Adaptor for respiratory assistance systems

ABSTRACT

An adaptor for a respiratory assistance system delivers aerosols to a patient. The adaptor is lightweight with a small footprint to increase patient comfort. The adaptor has a nozzle and a sealing mechanism to maintain pressure therein regardless of whether the nozzle is inserted into the adaptor. The adaptor is configured to connect to medical tubing and a medicament delivery device.

FIELD OF THE DISCLOSURE

The present disclosure generally relates to delivering medical gases toa patient. More particularly, the present disclosure relates to anadaptor or patient interface or both configured to couple with arespiratory assistance system to deliver medical gases to an infant.This application claims priority from provisional patent applicationsU.S. 62/427,796 and U.S. 62/375,405, the entire contents of each ofwhich are hereby incorporated by reference.

BACKGROUND

Gases delivery adaptors are configured to couple between a medicalapparatus and a patient interface to aid with the delivery of gases oraerosolised substances.

Respiratory systems may deliver conditioned gases to a patient. Gasesare heated and humidified prior to delivery to mimic the transformationof gases that occurs as they travel from the nose to the lungs in ahealthy individual. This improves airway defence and gases exchange inthe lungs when compared with the delivery of cold, dry gases to apatient. Medicament delivery devices, for example, nebulisers, capillaryaerosol generators or metered dose inhalers (MDIs) couple withrespiratory systems to deliver medicaments, such as aerosols, drypowders or aerosolised surfactant to a patient during respiratorytreatment. Adaptors are used to couple medicament delivery devices withrespiratory systems.

Bubble Continuous Positive Airway Pressure (CPAP) is a therapy that canprovide respiratory support to infants. This includes maintaining thefunctional residual capacity of the lungs, which can help to prevent theairways from closing and maintains the energy reserves of infantswithout requiring invasive ventilation. Gases delivered to patients viaa bubble CPAP system may be heated and humidified, which minimisesairway drying and inflammation, while improving secretion clearance andventilation. As a result, use of a conditioned bubble CPAP system mayreduce the time an infant is hospitalised. Bubble CPAP therapy can bedelivered using a patient interface, such as a mask, or nasal prongs.Aerosols can be administered to a patient through the patient interface.

SUMMARY

A medical gases delivery adaptor is disclosed herein in variousembodiments. The adaptor comprises a housing with an inlet port and anoutlet port that couples with medical tubing. A patient interfacecouples with the housing to deliver gases to a patient. The housing caninclude a nozzle that is configured to fluidly couple with a medicamentdelivery device, and can be configured to deliver aerosolised gases,medicament or aerosolized surfactant or aerosolized drugs or aerosolizedmedicament to the patient.

For purposes of summarising the present disclosure, certain aspects,advantages and novel features of the disclosed apparatus and systemshave been described herein. It is to be understood that not necessarilyall such advantages may be achieved in accordance with any particularembodiment of the disclosure. Thus, the disclosed apparatus and systemsmay be embodied or carried out in a manner that achieves or optimisesone advantage or group of advantages as taught herein withoutnecessarily achieving other advantages as may be taught or suggestedherein.

According to at least one aspect of the present disclosure, arespiratory system component can include one, some, or all of thefollowing features, as well as other features described herein. Therespiratory system component comprises a housing, an inlet port, and anoutlet port. The housing comprises a first end and a second end. Thehousing defines a passageway between the first end and the second end.The inlet port is coupled with the housing. The inlet port is configuredto couple with a first conduit. The outlet port is coupled with thehousing. The outlet port is configured to couple with a second conduit.The first end of the housing can be fluidly connected to a nozzle. Insome examples, the nozzle can deliver drug to the housing and to thepatient. The second end of the housing can be configured to couple witha patient interface.

In some embodiments, the housing can optionally include at least oneclip configured to facilitate attachment of a headgear to therespiratory system component. The respiratory system component canoptionally include a coupling surface in fluid communication with thesecond end of the housing. The coupling surface can optionally beconfigured to receive the patient interface by a friction fit. Thepatient interface can optionally include nasal prongs or a nasal mask.The nozzle can optionally be configured to fluidly connect thepassageway of the housing with a medicament delivery device.

In some embodiments, disclosed is an adaptor for medicament deliverycomprising a tubular body, a housing, and a patient interface. In someembodiments, the tubular body has a first end and a second end andincludes an inlet tube, an outlet tube, and a surfactant delivery tube.The inlet tube can include an inlet port at the first end and an outletat the second end, wherein the inlet port is configured to be connectedto an inspiratory conduit for receiving a flow of gases. The outlet tubecan be adjacent to the inlet tube having an outlet port at the first endand an inlet at the second end, wherein the outlet port is configured tobe connected to an expiratory conduit for dispensing the flow of gases.The surfactant delivery tube can be adjacent to a portion of at leastone of the inlet tube and the outlet tube and can include an inlet portat the first end and an outlet at a second end, wherein the inlet portis configured to connect to a source of medicament. In some embodiments,the housing includes a first end and a second end, wherein the first endof the housing is attached to the second end of the tubular body. Thepatient interface can be configured to be connected to the second end ofthe housing, wherein the patient interface is in fluid communicationwith an airway of a patient.

In other embodiments, the adaptor can include a housing that ispermanently attached to the tubular body. In other embodiments, theadaptor includes a tubular body and housing comprising a rigid plastic.In other embodiments, the adaptor includes a flow of medicamentcomprising an aerosolized surfactant.

In other embodiments, the adaptor has a housing that includes a dividerto separate the flow of gases from a flow of medicament. In someembodiments, at least a portion of the housing of the adaptor isconfigured to allow the flow of gases to mix with the flow ofmedicament. In some embodiments, the adaptor includes a divider thatcomprises angled sidewalls. In some embodiments, the adaptor includes adivider that further comprises a rounded portion connecting the angledsidewalls to improve fluid flow around corners. In some embodiments, theadaptor includes a divider that is configured to provide a plurality offluid entryways into an interior of an undivided portion of the housing.In some embodiments, the adaptor includes a divider that comprisesstraight walls to form rectangular fluid entryways to the interior ofthe undivided portion of the housing. In some embodiments, the adaptorincludes a housing wherein a cross-section of a portion of the housingin fluid communication with the surfactant delivery tube is greater thana cross-section of a portion of the housing in fluid communication withthe inlet tube and the outlet tube, and wherein the greatercross-section of the portion of the housing in fluid communication withthe surfactant delivery tube is configured to reduce deposition ofmedicament within the surfactant delivery tube.

In other embodiments, the adaptor includes a patient interfacecomprising a pair of prongs. In some embodiments, the adaptor includesnasal prongs that are sized to fit the nares of the patient. In someembodiments, the adaptor includes a patient interface that is configuredto interchangeably attach to a plurality of different nasal prong sizes.In some embodiments, the adaptor includes a patient interface that ispress-fit onto the second end of the housing. In some embodiments, theadaptor comprises a patient interface that is removably connected to thesecond end of the housing.

In other embodiments, the adaptor comprises a tubular body that furthercomprises a pressure port connected to a pressure sensor, wherein thepressure sensor is configured to measure air pressure flowing throughthe pressure port. In other embodiments, the adaptor comprises a tubularbody that further comprises a pressure tube connected to the housing. Inother embodiments, the adaptor comprises a pressure port and an inletport of the surfactant delivery tube that are on opposing sides of theadaptor. In other embodiments, the adaptor comprises a tubular bodyhaving an elongated oval cross-section.

In other embodiments, the adaptor comprises an inlet port havingthreading to connect to an inspiratory conduit, and an outlet porthaving threading to connect to an expiratory conduit. In someembodiments, the adaptor comprises an inlet port and an outlet portwherein a portion of the inlet port and the outlet port are tapered. Insome embodiments, the adaptor comprises an inlet port and outlet portthat are tapered to 15 mm or 22 mm.

In other embodiments, the adaptor can further comprise at least one clipconnectable to an interface stabilization mechanism. In someembodiments, the adaptor includes an interface stabilization mechanismthat comprises headgear.

In other embodiments, the adaptor comprises a retaining systemcomprising a two-part releasable attachment system comprising aninterface patch and a dermal patch. In some embodiments, the adaptorcomprises a two-part releasable attachment system that is foldable. Insome embodiments, the adaptor comprises a two-part releasable attachmentsystem that is configured to retain at least one of a surfactant tube, apressure sensor line, and a feeding tube. In some embodiments, theadaptor comprises a two-part releasable attachment system that comprisesa dynamic interface having a hinge configured to conform the dynamicinterface to the shape of the face of the patient, and wherein thedynamic interface is configured to maintain the position of the prongson the face of the patient by minimizing movement of the prongs.

In other embodiments, the adaptor further comprises a foam blockconfigured to stabilize the adaptor on the face of the patient. In otherembodiments, the adaptor is configured such that the bias air flow paththrough the adaptor occurs upstream from the flow of medicament.

In the above disclosed embodiments, surfactant (e.g. medicament) can bedelivered to the air flow path after the exchange of air from the inletlumen and the outlet lumen ensures less dilution of the surfactant tothe infant as well as reducing the deposition of the surfactant on theinterior of the adaptor. In some examples, the inside of the housing caninclude a divider that divides the housing to provide a housing airflowentrance fluidly connected to a housing airflow pathway and a housingsurfactant entrance fluidly connected to a housing surfactant pathway.The housing airflow pathway is configured to fluidly connect with boththe inlet lumen and the outlet lumen. Similarly, the housing surfactantlumen can be configured to fluidly connect with the surfactant pathway.As discussed above, this can allow surfactant to flow from thesurfactant pathway into the housing surfactant pathway without mixingwith the inspiratory air from the inlet lumen.

In some embodiments, disclosed is an adaptor for medicament deliverycomprising a tubular body, a housing, and a patient interface. In someembodiments the tubular body includes a first end and a second end,wherein the tubular body can include an inlet tube and an outlet tube.The inlet tube can include an inlet port at the first end and an outletat the second end, wherein the inlet port is configured to be connectedto an inspiratory conduit for receiving a flow of gases. The outlet tubecan be adjacent to the inlet tube having an outlet port at the first endand an inlet at the second end, wherein the outlet port is configured tobe connected to an expiratory conduit for dispensing the flow of gases.In some embodiments, the housing includes a first end and a second end,wherein the first end of the housing is attached to the second end ofthe tubular body. In some embodiments, the housing comprises asurfactant delivery tube wherein the surfactant delivery tube comprisesan inlet port configured to connect to a source of medicament and abifurcated outlet. The bifurcated outlet can be configured to delivermedicament to the nares of a patient. In some embodiments, the patientinterface can be configured to be connected to the second end of thehousing, wherein the patient interface is in fluid communication with anairway of a patient.

In other embodiments, the adaptor can include a housing that ispermanently attached to the tubular body. In other embodiments, theadaptor includes a tubular body and housing comprising a rigid plastic.In other embodiments, the adaptor includes a flow of medicamentcomprising an aerosolized surfactant.

In other embodiments, the adaptor includes a patient interfacecomprising a pair of prongs. In some embodiments, the adaptor includesnasal prongs that are sized to fit the nares of the patient. In someembodiments, the adaptor includes a patient interface that is configuredto interchangeably attach to a plurality of different nasal prong sizes.In some embodiments, the adaptor includes a patient interface that ispress-fit onto the second end of the housing. In some embodiments, theadaptor comprises a patient interface that is removably connected to thesecond end of the housing.

In other embodiments, the adaptor comprises a tubular body that furthercomprises a pressure port connected to a pressure sensor, wherein thepressure sensor is configured to measure air pressure flowing throughthe pressure port. In other embodiments, the adaptor comprises a tubularbody that further comprises a pressure tube connected to the housing. Inother embodiments, the adaptor comprises a pressure port and an inletport of the surfactant delivery tube that are on opposing sides of theadaptor. In other embodiments, the adaptor comprises a tubular bodyhaving an elongated oval cross-section.

In other embodiments, the adaptor comprises an inlet port havingthreading to connect to an inspiratory conduit, and an outlet porthaving threading to connect to an expiratory conduit. In someembodiments, the adaptor comprises an inlet port and an outlet portwherein a portion of the inlet port and the outlet port are tapered. Insome embodiments, the adaptor comprises an inlet port and outlet portthat are tapered to 15 mm or 22 mm.

In other embodiments, the adaptor can further comprise at least one clipconnectable to an interface stabilization mechanism. In someembodiments, the adaptor includes an interface stabilization mechanismthat comprises headgear.

In other embodiments, the adaptor comprises a retaining systemcomprising a two-part releasable attachment system comprising aninterface patch and a dermal patch. In some embodiments, the adaptorcomprises a two-part releasable attachment system that is foldable. Insome embodiments, the adaptor comprises a two-part releasable attachmentsystem that is configured to retain at least one of a surfactant tube, apressure sensor line, and a feeding tube. In some embodiments, theadaptor comprises a two-part releasable attachment system that comprisesa dynamic interface having a hinge configured to conform the dynamicinterface to the shape of the face of the patient, and wherein thedynamic interface is configured to maintain the position of the prongson the face of the patient by minimizing movement of the prongs.

In other embodiments, the adaptor further comprises a foam blockconfigured to stabilize the adaptor on the face of the patient. In otherembodiments, the adaptor is configured such that the bias air flow paththrough the adaptor occurs upstream from the flow of medicament.

In the above disclosed embodiments, the adaptor can include anintegrated nozzle that is configured to connect with an external deviceto provide a fluid connection with the inside of the housing. In someexamples, the nozzle can be disposed about another conduit to isolateand restrict the mixing of the aerosolized material (for example, adrug) with the air flow coming through the inlet tube. For example, thenozzle can be disposed about a surfactant tube. The surfactant tube canbe configured to be fluidly connected to the respiratory assistancesystem to allow the delivery of a substance, such as an aerosolizedsurfactant, to the housing and to the patient through the patientinterface. In some examples, the surfactant tube can have a bifurcatedportion that allows the surfactant tube to be fluidly connected to bothnostril lumens of the nasal prongs so as to allow medicament to bedelivered through both nostrils of the patient.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features, aspects and advantages of the presentdisclosure will be described with reference to the following drawings,which are illustrative but should not be limiting of the presentdisclosure.

FIG. 1 illustrates an example respiratory system.

FIGS. 2A-2F illustrate a plurality of views of an adaptor for arespiratory system according to an embodiment of the disclosure.

FIG. 2G illustrates an enlarged view of an embodiment of the surfactanttube that can be found in the adaptor of FIGS. 2A-2F that guide air flowinto the nostril lumens of the patient interface and into the patient.

FIGS. 3A-3H illustrate a plurality of views of an adaptor for arespiratory system according to another embodiment of the disclosure.

FIGS. 4A-4E illustrate a plurality of views of an adaptor for arespiratory system according to another embodiment of the disclosure.

FIGS. 5A-5G illustrate a plurality of views of an adaptor for arespiratory system according to another embodiment of the disclosure.

FIGS. 6A-6I illustrate a plurality of views of an adaptor for arespiratory system according to another embodiment of the disclosure.

FIGS. 7A-7G illustrate a plurality of views of an adaptor for arespiratory system according to another embodiment of the disclosure.

FIGS. 8A-8F illustrate a plurality of views of an adaptor for arespiratory system according to another embodiment of the disclosure.

FIGS. 9A-9E illustrate a plurality of views of the housing of therespiratory system of FIGS. 8A-8F.

FIGS. 10A-10C illustrate a plurality of views of a housing of an adaptorfor a respiratory system according to another embodiment of thedisclosure.

FIGS. 11A-11C illustrate a plurality of views of a housing of an adaptorfor a respiratory system according to another embodiment of thedisclosure.

FIGS. 12A-12D illustrate a plurality of views of a housing of an adaptorfor a respiratory system according to another embodiment of thedisclosure.

FIGS. 13A-13B illustrate an embodiment of a removable attachment for aninterface stabilising mechanism.

FIGS. 14A-14D illustrate an embodiment of an attachment mechanism forsecuring a user interface and/or user interface tubing to a patient.

FIGS. 15A-15C illustrate an embodiment of an attachment mechanismcomprising a dynamic interface.

FIGS. 16A-16C illustrate another embodiment of the attachment mechanismcomprising a dynamic interface.

FIG. 17 illustrates another embodiment of the attachment mechanismcomprising a dynamic interface.

FIG. 18 illustrates an embodiment of a securement system comprising atwo-part releasable attachment or connection arrangement.

FIG. 19 illustrates another embodiment of the securement systemcomprising a two-part releasable attachment or connection arrangement.

FIG. 20 illustrates another embodiment of the securement systemcomprising a two-part releasable attachment or connection arrangement.

FIGS. 21A-21B illustrate an embodiment of a fixation structureconfigured to secure the pressure lumen and/or surfactant lumen to theface of the patient.

DETAILED DESCRIPTION

FIG. 1 illustrates an example of a respiratory assistance system 1configured to provide respiratory gases to a patient. In the illustratedembodiment, the patient is an infant; however the patient could also bean adult or a child. The respiratory assistance system 1 can include agases source 2 that supplies gases to a humidification apparatus 3. Thehumidification apparatus 3 can condition the gases before passing themvia an inspiratory tube 6 to a patient by a patient interface 5. In someexamples, the patient interface 5 can be nasal prongs or a nasal mask.In some embodiments, the patient interface 5 may be configured to besealingly positioned on the face of the patient. Upon exhalation of thepatient, the gases are passed through an expiratory tube 4 to a pressureregulating device 7. In some embodiments, the pressure regulating device7 is a ventilator or bubbler. The patient interface 5 couples to theinspiratory tube 6 and to the expiratory tube 4 using an adaptor 100.Alternative respiratory assistance systems can include a single tube,for example inspiratory tube 6, which can allow exhalation to occurthrough the patient interface 5 and/or the adaptor 100. Thus, theadaptor 100 can couple the patient interface 5 to the single tubesystem.

Prior art adaptors configured to deliver aerosols to a patient are bulkyand heavy in use and may cause discomfort to the patient. As a result,such adaptors are often only temporarily coupled to the patient duringaerosol treatment. This results in high user effort to install and thento remove these adaptors, which can impact the treatment delivered tothe patient. Other prior art adaptors provide poor sealing mechanismsbetween the adaptor and the coupling region of a medicament deliverydevice, which causes significant pressure losses in the system.

FIGS. 2A-2F, 3A-3H, 4A-4G, 5A-5G, 6A-6I, and 7A-7G illustrate exampleembodiments of adaptors that address many of the disadvantages ofexisting adaptors. The disclosed adaptors can include features thatallow it to remain in place during the use of the medical system. Thus,the adaptor may not require removal following aerosol treatment of thepatient. For example, the adaptor can form an integral part of thepatient interface 5. This can include, for example, a continuouspositive airway pressure (CPAP) interface and/or may include featuresthat enable delivery of medicament via the integrated adaptor.

In the aforementioned embodiments the adaptor can include a housing thatis fluidly connected to a plurality of conduits to provide fluid flow,such as air, and the delivery of aerosolized surfactants to the patientthrough the patient interface. In addition to the housing, the adaptorcan include an inlet port, an outlet port, a surfactant port, and acoupling surface for engaging a patient interface. In some embodiments,the adaptor can also include a pressure tube with a pressure port and apressure lumen that is fluidly connected to the housing.

In some embodiments, the adaptor can include an integrated nozzle thatis configured to connect with an external device to provide a fluidconnection with the inside of the housing. In some examples, the nozzlecan be disposed about another conduit to isolate and restrict the mixingof the aerosolized material (for example, a drug) with the air flowcoming through the inlet tube. For example, the nozzle can be disposedabout a surfactant tube. The surfactant tube can be configured to befluidly connected to the respiratory assistance system to allow thedelivery of a substance, such as an aerosolized surfactant, to thehousing and to the patient through the patient interface. In someexamples, the surfactant tube can have a bifurcated portion that allowsthe surfactant tube to be fluidly connected to both nostril lumens ofthe nasal prongs so as to allow medicament to be delivered through bothnostrils of the patient.

As will be discussed in more detail below, in the embodimentsillustrated in FIGS. 2A-2F, 3A-3H, 4A-4G, 5A-5G, 6A-6I, and 7A-7G, thebody of the adaptor can be divided into a plurality of compartments. Theplurality of compartments within the adaptor can reduce premixing of themedicament received through the surfactant port and the inspiratorygases through the inlet lumen and reduce dilution of the drug by theoutgoing gases through the outlet port. In some examples, thearrangement of the conduits within the adaptor can help to maximize gasflow to the patient. For example, inspiratory gases can enter theadaptor through the inlet port and flow through the inlet lumen and intothe housing. There, the gases can mix with the medicament delivered fromthe bifurcated portion surfactant tube near the opening of the nostrillumens. The expiratory gases can then exit the patient interface andmove around the surfactant tube, flow through the outlet lumen, and exitthe adaptor from the outlet port.

FIGS. 8A-8F, 9A-9E, 10A-10C, 11A-11C, and 12A-12D illustrate anotherembodiment of adaptors that also address many of the disadvantages ofexisting adaptors. As with the adaptors illustrated in FIGS. 2A-2F,3A-3H, 4A-4G, 5A-5G, 6A-6I, and 7A-7G, the adaptors in FIGS. 8A-8F,9A-9E, 10A-10C, 11A-11C, and 12A-12D similarly can include features thatallow it to remain in place during the use of the medical system. Thus,the adaptor may not require removal following aerosol treatment of thepatient. For example, the adaptor can form an integral part of thepatient interface 5. This can include, for example, a continuouspositive airway pressure (CPAP) interface and/or may include featuresthat enable delivery of medicament via the integrated adaptor.

In the aforementioned embodiments, the adaptors are similar to theadaptors disclosed in FIGS. 2A-2F, 3A-3H, 4A-4G, 5A-5G, 6A-6I, and7A-7G. In some examples, the adaptors can include a housing that isfluidly connected to a plurality of conduits to provide fluid flow, suchas air, and the delivery of aerosolized surfactants to the patientthrough the patient interface. In addition to the housing, the adaptorcan include an inlet port, an outlet port, a surfactant port, and acoupling surface for engaging a patient interface. In some embodiments,the adaptor can also include a pressure tube with a pressure port and apressure lumen that is fluidly connected to the housing.

The adaptors illustrated in FIGS. 8A-8F, 9A-9E, 10A-10C, 11A-11C, and12A-12D can have a housing that is configured to keep the surfactantflow path out of the bias flow path such that the inlet lumen and outletlumen are fluidly connected before surfactant is delivered to the airflow path. Delivering surfactant to the air flow path after the exchangeor in parallel to the bias flow of air from the inlet lumen and theoutlet lumen ensures less dilution of the surfactant to the infant aswell as reducing the deposition of the surfactant on the interior of theadaptor.

In some examples, the inside of the housing can include a divider thatdivides the housing to provide a housing airflow entrance fluidlyconnected to a housing airflow pathway and a housing surfactant entrancefluidly connected to a housing surfactant pathway. The housing airflowpathway is configured to fluidly connect with both the inlet lumen andthe outlet lumen. Similarly, the housing surfactant lumen can beconfigured to fluidly connect with the surfactant pathway. As discussedabove, this can allow surfactant to flow from the surfactant pathwayinto the housing surfactant pathway without mixing with the inspiratoryair from the inlet lumen.

The divider can provide two separate compartments for theinspiratory/expiratory airflow and the surfactant flow. The housing,near the housing exit, includes an undivided portion that allows theinspiratory air from the inlet lumen to mix with the surfactant from thesurfactant lumen before being delivered to the patient. The divider goesthrough a turn section but the turn portion includes rounded edges toreduce aerosolized surfactant deposition at the turn. The housingairflow pathway provides inspiratory airflow into the undivided portionto allow mixing of inspiratory airflow and aerosolized surfactant.

Existing respiratory assistance systems 1 require a user to remove thepatient interface temporarily to replace it with a medicament deliveryinterface, following which the patient interface is restored to thepatient. This configuration may cause patient discomfort and may reducethe efficacy of the treatment. As a result, a patient may be more likelyto undergo invasive procedures, due to disturbances during treatment.

In some examples, the adaptor can be integrated with the patientinterface 5. Integration of the adaptor and the patient interface canreduce the number of steps a user is expected to perform to install andremove the adaptor, improving the usability of the system. Use of theadaptor throughout the treatment duration can reduce the likelihood ofcomplications during treatment, and reduces the number of disturbancesduring the treatment.

In some examples, the adaptor can have an optimised construction thatallows it to maintain a small footprint which can increase patientcomfort. In some examples, the small footprint of the adaptor can allowthe adaptor to provide aerosolized therapy while still retaining thesize and weight of a normal CPAP interface. This interface can allow theadaptor to have similar usability as other CPAP interfaces.

In some examples, the adaptor is configured such that it is not bulky orheavy for the patient, and thus may be perceived to be less obstructive.To increase patient comfort, the size of the adaptor can be reduced tolimit the amount the adaptor covers/blocks the patient's face from view

In other examples, patient comfort can be increased by reducing theweight of the adaptor 100. For example, the adaptor and patientinterface 5 can be configured such that it does not weigh more than anybaby for whom the device could be configured for use (e.g. pretermbaby). In some examples, the weight of the adaptor and patient interface5 can weigh approximately 100-500 grams. In other examples, the adaptorand patient interface 5 can weigh less than 100 grams or more than 500grams. In other examples, the adaptor and patient interface 5 can weighbetween 15-30 grams. In other examples, the adaptor and interface 150can weigh 15 grams, 16 grams, 17 grams, 18 grams, 19 grams, 20 grams, 21grams, 22 grams, 23 grams, 24 grams, 25 grams, 26 grams, 27 grams, 28grams, 29 grams, or 30 grams.

Use of an integrated system to deliver gases to a patient can improveusability and reduce patient discomfort. For example, the adaptor can bedesigned to deliver sufficient gases to the patient in normal use. Thus,the adaptor can remain in place during the ventilation of the patient.Although the present disclosure describes an adaptor for use with arespiratory system, embodiments of the adaptor may be used with othermedical systems, for example, a surgical system such as for laparoscopicor open surgery.

Turning first to FIGS. 2A and 2B, illustrated is an embodiment of theadaptor 100. The adaptor 100 can include a housing 120 that is fluidlyconnected to a plurality of conduits to provide fluid flow, such as air,and the delivery of aerosolized surfactants to the patient through thepatient interface 150. The adaptor 100 can include a housing 120, aplurality of clips 130, an inlet port 160, an outlet port 180, asurfactant port 110, and a coupling surface 140 for engaging a patientinterface 150.

In some examples, the housing 120 can include a substantially hollowcylindrical body. The shape of the housing 120 can be optimised toreduce resistance to flow within the housing 120. In some examples, thehousing 120 can comprise different shapes, for example, rectangular,square, hexagonal, or semi-circular. In some embodiments, the shape ofthe housing 120 can minimize volume within the housing 120. This canreduce dead space—therefore reducing the build-up of carbon dioxidewithin the housing 120. The housing 120 can be compact so as to reducethe weight and bulk of the housing 120 and improve patient comfort. Asmentioned above, and discussed in more detail below, the housing 120 canbe configured to both receive gases through an inspiratory tube and aidthe exit of gases through an expiratory tube.

The housing 120 can include a coupling surface 140 at an end of thehousing 120 that is proximate to the patient. As illustrated in FIGS.2A-2B, the coupling surface 140 can be rectangular in cross-section. Thecoupling surface 140 can include a first end that is fluidly connectedwith the housing 120 and a second end that is configured to couple withthe patient interface 150. The second end of the coupling surface 140can allow fluid communication between the housing 120 and the patientinterface 150. In some embodiments, a partial barrier can exist betweenthe housing 120 and the first end of the coupling surface 140. Anorifice can thus maintain fluid communication between the housing 120and the patient interface 150. The orifice can direct the flow of gasestoward the patient interface 150. In some examples, the orifice cancontrol the pressure of the gas flow as it enters the patient interface150.

In some embodiments, the patient interface 150 can be configured toremovably couple with the coupling surface 140. In some examples, thepatient interface 150 can be coupled with the coupling surface 140 usingadhesives or mechanical mechanisms such as snap-fit mechanisms. In someembodiments, the patient interface 150 can be permanently attached tothe coupling surface 140 using adhesives, snap-fit mechanisms, orwelding techniques. In some embodiments, the coupling between thepatient interface 150 and the coupling surface 140 can have a frictionfit. FIGS. 2A-2F illustrate a patient interface 150 that is transparentso as to allow the engagement between the coupling surface 140 and thepatient interface 150 to be visualized. The patient interface 150 caninclude a substantially hollow complementary region 155 that isconfigured to receive the coupling surface 140. As will be described inmore detail below, an embodiment of the complementary region of thepatient interface can be visualized in FIG. 2G. In some embodiments, thecoupling surface 140 can be configured to receive the complementaryregion 155 of the patient interface 150. In some embodiments, thepatient interface 150 can be permanently coupled with the adaptor 100.This can provide a fully integrated adaptor, which may improve theusability of the adaptor 100.

As illustrated in FIGS. 2A-2B, in some examples, the patient interface150 can include nasal prongs 152. In some embodiments, the patientinterface 150 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 100can be adapted for use in a surgical application. The patient interface150 can include a diffuser, trocar, or catheter.

In some embodiments, the adaptor 100 can include a retention system,which may comprise clips 130 that are positioned on first and secondsides of the housing 120. As illustrated in FIGS. 2A-2B, the first andsecond sides of the coupling surface 140 can be substantiallyperpendicular to the first and second ends of the coupling surface 140.In some embodiments, the clips 130 can be configured to be mobile clips.For example, the clip 130 can be positioned on a slidable and/orrotatable bar or cord. In this way, the position of the clips 130 can berotated or altered to simplify the attachment of the patient stabilisingmechanism to the adaptor 100. In some embodiments, the clips 130 can beconfigured to permanently attach to an interface stabilising mechanism.

In some examples, the clips 130 can engage a removable attachment thatis attached to an interface stabilising mechanism, such as headgear or ahat or bonnet. In some examples, the removable attachment is a loop. Insome embodiments, the removable attachment is a clipping mechanism. Anexample of the removable attachment is illustrated in FIGS. 13A and 13B.As illustrated in FIG. 13A, the clip 130 can hook onto a loop of theremovable attachment. The removable attachment can be looped onto alength of fabric that is attached to a portion of the interfacestabilising mechanism. FIG. 7B illustrates the removable attachment ofthe interface stabilising mechanism.

In some embodiments, as illustrated in FIGS. 13A-13B, the clips 130 cancomprise C-shaped protrusions. In some embodiments, the clips 130 can beL-shaped protrusions, clipping mechanisms, adhesives, or a hook and loopmechanism. The clips 130 can be configured to attach to the interfacestabilising mechanism in a simple yet effective mechanism. This canenable the patient interface 150 to be positioned correctly and stablyon the patient.

In some embodiments, the retention system can be a two-part releasableattachment mechanism. Several such two-part releasable attachmentmechanisms are described in the Applicants' U.S. application Ser. No.13/880,036, filed on Oct. 18, 2011 and PCT App. No. PCT/NZ2016/050041,filed on Mar. 16, 2016 each hereby incorporated by reference.

An example of the attachment mechanism of Applicant's U.S. applicationSer. No. 13/880,036 is hereby reproduced as FIGS. 14A-14D. Theattachment mechanism can be configured for securing a user interfaceand/or user interface tubing to a patient as illustrated in FIG. 14A.The attachment mechanism 1100 is illustrated supporting a nasal cannulaon an infant's face, but can be adapted to support the disclosed adaptorof the present application using the same principles, such as byincluding an extension portion attachable to a patch instead of clips130.

In some embodiments, the attachment mechanism provides for a generallymore rapid and improved or simplified ease of installation of a userinterface into an operational position on a user. Further, thesebenefits may also contribute to improved or simplified ease ofapplication of alternative user interfaces or removal of a userinterface from a user when cycling a user between different therapies(such as gas treatments, e.g. CPAP or high-flow applications). Invarious embodiments provided by the attachment mechanism, such anattachment mechanism may provide for quick location of an interface to auser, and may provide for the secured positioning of the interface.

In some embodiments, the ease with which a user interface may bepositioned for a user is particularly useful. Providing a system wherebya carer (e.g. nurse) is able to apply the securement system with asingle hand, particularly where the interface user is an infant, can beparticularly advantageous.

In addition, in another embodiment, the attachment mechanism providesfor a first level of securement of a user interface to a user. Forexample, such a first level of securement may be that as shown by FIGS.14A-14B. Where a user requires additional or heightened security of userinterface positioning or securement, a secondary level of interfacesecurement can be utilized. Such an additional level may includeapplication of an over patch, such as that provided, for example, bypatch 1260 illustrated in FIGS. 14D-14E. Such a patch 1260 may be anadhesive patch and can be installed over the top of the user interfaceand/or tubing and adhered to a portion of the dermal patch 1150 (FIG.14B).

The attachment mechanism 1100 comprises a two-part releasable attachmentor connection arrangement 1151. The releasable connection arrangement1151 acts between a pair of patches that are affixed to the patient andthe user interface respectively.

The first patch can be a dermal patch 1150 that is adhered or otherwiseattached to the patient's skin. The dermal patch can have a user sidethat faces the user's skin and an interface side that faces the userinterface. The user side of the dermal patch 1150 may be attached to theskin of a user by a dermatologically sensitive adhesive, such as ahydrocolloid. The user interface side of the dermal patch can beprovided with the first part 1153 of the two-part releasable attachmentor connection system 1151.

The second patch can be a user interface patch 1152. The user interfacepatch 1152 can also have a patient side and an interface side. Thepatient side of the user interface patch 1152 can be disposed adjacentthe dermal patch when the attachment mechanism 1100 is engaged. Thecomplimentary second part of the two-part releasable attachment orconnection system 1153 can be affixed to the patient side of the userinterface patch 1152, so that the respective parts of the two-partreleasable attachment or connection system 1151 are easily engagablewhen the patches 1150, 1152 are brought together. The interface side ofthe user interface patch 1152 can be affixed to the user interface. Theuser interface patch may be integrated with or suitably adhered to theuser interface.

In some examples, a part or corner of the user interface patch 1152 mayinclude a region that does not attach to the dermal patch 1150. Thegeneral purpose of this can be to allow a region (or tab) that can bemore easily gripped by a user or carer for removing or detaching theinterface from the dermal patch.

The two-part releasable attachment or connection arrangement 1151 maycomprise a hook and loop material (such as Velcro™), a magnet or anarray of magnets disposed on the respective patches with the polessuitably arranged, an adhesive arrangement that is activated when thepatches are urged together or another suitable releasable suitablecoupling. The interface side of the dermal patch 1150 may have one of ahook or a loop material, and the patient side of the user interfacepatch 1152 may have the other of the hook or loop material, such thatthe dermal and user interface patches are releasably attachable orconnectable to each other.

When a hook and loop material is referenced, a hook and loop materialcan mean any one of a wide variety of area type mechanical fasteners.For example, the Velcro™ product range can include hook and loop productwhere the hook component includes upstanding nylon hooks (formed as cutloops through a woven backing web) which engage with any complimentaryloop pile material. The Velcro™ range can also include extruded hookproducts, typically of a smaller size and which mate with “fluffy”non-woven fiber backing materials. These hook materials are designed towork with a range of loop substrates and in some cases, these hookmaterials act as loop substrates as well. Other similar systems includethe Dual-Lock™ reclosable fastener system from 3M of St Paul, Minn. USA.The common feature of these releasable fastening systems is that theyengage at any part of the contact between the two parts of the system.Precise alignment of individual connectors is not required because amultitude of connectors are distributed across the area of the product.A wide range of releasable fastener systems within this field may beused in the releasable attachment mechanism for providing releasableattachment between the dermal patch and the user interface.

The first part of the two-part releasable attachment or connectionsystem may be adhered to the user interface side of the dermal patchwith a suitable adhesive and occupy up to 100% or less than about 90%,or about 85%, or about 75%, or about 60% or about 50% or about 40% orabout 30% or about 20% or about 10% of the interface side surface areaof the dermal patch. In some embodiments, the dermal patch 1150 is agenerally planar pad having a thickness much less than both its widthand its length. In some embodiments, the pad has an overall oval shape,but may take other shapes.

The pad can also include a first part 1153 of the two-part releasableattachment mechanism 1151. In some embodiments, the construction of thedermal patch is such that the first part 553 of the releasableattachment mechanism comprises a substrate and multitude of fastenerelements (with effective hooks, effective loops or other elements)provided across the area of the substrate. The substrate is secured tothe body of the dermal patch. In some embodiments, the substrate issecured by adhesive or by direct bonding during forming of the dermalpatch.

In some embodiments, the substrate can be smaller in area than thedermal patch and is located on the dermal patch so that it does notreach any edge of the dermal patch. In this way, the edge of thesubstrate can be spread from the edge of the dermal patch all around theperimeter of the substrate.

In some embodiments, the substrate for the first part of the two-partreleasable attachment system can be flexible such that the plane of thesubstrate may bend to follow a surface that is curved in one direction.However, the substrate is typically not also stretchable to be able tofollow a surface curved in two orthogonal directions. However, the padis of the dermal patch may be stretchable and conformable to surfacescurved in more than one direction such as may be required to conform tothe contours of the location of placement on the patient. According tosome embodiments, this difficulty is alleviated by providing a firstpart 1153 of the two-part releasable mechanism in a form wherein theportion of substrate is divided by at least one slit or at least oneslot into regions such that that different parts of the substrateportion may bend independently and thus the overall form of thesubstrate portion may deform to substantially match a surface curved intwo directions. This will be the case even though the substrate portionis only curved in one direction at any individual location on thesubstrate portion.

Another embodiment of the attachment mechanism is illustrated in FIGS.14C-14D. The attachment mechanism 1200 can comprise a dermal patch 1250and a securing patch 1260. The securing patch 1260 can extend over theuser interface and/or tubing and adheres to the dermal patch 1250 tosecure the interface and/or tubing to the patient. The dermal patch 1250can define a securement footprint that is attached to the patient andhas a similar configuration to the corresponding dermal patch 1150 inthe above described attachment mechanism. The user side of the dermalpatch 1250 is configured to attach or adhere to the user's skin.

The securing patch 1260 can extend over the user interface and/orassociated user interface tubing and affixes to the dermal patch 1250 tosecure the user interface to the patient. The securing patch 1260 andthe dermal patch 1250 can be configured so that the securing patch canbe contained within or bounded by the securement footprint of the dermalpatch when the securement system is applied to a patient with a suitableor compatible user interface. Containing the securing patch 1260 withinthe dermal patch 1250 securement footprint can reduce the likelihood ofunnecessary contact with the patient's skin and the potential forirritation. Ideally, the dermal patch 1250 can have the same or agreater surface area than the securing patch 1260. The dermal patch 1250may include one part of a two-part mechanical fastener system across itssurface or parts of its surface, with the securing patch 1260 having theother part of the fastening system.

In this manner, the dermal patch can be sized to reduce the likelihoodof the taping or any additional taping to extend onto the skin of theuser. Avoiding or minimizing the application, or repeated applicationand removal, of adhesives to a user's skin is preferred. This embodimentbeneficially reduces the likelihood of repeated application of adhesive,or adhesive tape, to a user's skin for the installation and placement ofa user interface into an operational position. Adhesive tapes or otherdermal adhesive patches (when repeatedly applied and remove),particularly for infants, create problems. Problems include, but are notlimited to, skin irritation from adhesive chemicals (or adhesive removalchemicals, such as solvents) or tape materials (e.g. due to skinsensitivities), damage to user skin due to repeated application andremoval of dermal patches or tapes for positioning or re-positioning ofthe interface for the user. Re-positioning may be required oradjustments may be needed where treatment therapies are being cycled(i.e. changed from one type of treatment to another, and then backagain). Advantageously therefore, the described embodiments provide fora system of positioning or locating of a user interface for a user, yetreducing the likelihood of the problems associated with adhesive tapesattached to the users skin.

It should be appreciated there are a number of disadvantages andproblems associated with the re-positioning of an interface,particularly an infant interface. Included is “snub nosing”, epidermalabrasion, or dermal allergies from traditional taping techniques forapplication of user interfaces (e.g. nasal cannula) to users. Suchproblems are also incurred during the cycling of a user betweendifferent treatment options and, traditionally, the subsequent removalof headgear or tapes or user interfaces and then the installation of newequipment and user interfaces or interface positioning headgear or othergear. Therefore, provision of a securement system which, when applied toa user, is in a ready-to-receive mode for receiving a user interface isa useful step in progressing toward reducing the problems users havepreviously been faced with. Further, improving the ease of installation,both in terms of complexity as well as time and effort by a carer (e.g.nurse), is of further benefit.

The securement patch may be shaped or otherwise configured toaccommodate geometric or other features of the user interface and/orassociated user interface tubing. The illustrated securement patches canhave a plurality of wings 1261 that accommodate the user interfacetubing and increase the contact surface of the securing patch 1260exposed to the dermal patch 1250. The securing patches illustrated inFIGS. 14F-14D each have a pair of wings arranged at one end of thepatch. The wings 1261 can be configured to secure to the dermal patch oneither side of a user interface and/or associated user interface tubingand reduce the potential for the securing patch 1260 to bunch about theinterface and/or tubing.

The securement patch 1261 illustrated in FIG. 14D can also have a tubeend wing 1261. The tube end wing 1261 can be configured to extend underthe user interface tubing and affix to the dermal patch 1250 to link theends of the securing patch 1260.

The above described embodiments of the attachment mechanisms can be usedto secure tubing to any part of a patient's body. The embodimentsillustrated in FIGS. 14A-14D are configured to attach a user interfaceto a patient's face, in particular, adjacent the user's upper lip and/orcheek. The illustrated securing systems can be adapted for neonatalapplications.

The user side of the dermal patches 1150, 1250 can have adermatologically sensitive adhesive (such as a hydrocolloid) thatadheres the patch to a user's skin, so that application of therespective securing systems causes as little irritation as possible. Thedermal patches 1150, 1250 can have sufficient surface areas todistribute the adhesive and interface retention forces over an adequatearea of the user's face to reduce localized pressure build up.

The illustrated securement systems are particularly configured toreceive and/or secure the disclosed adaptor and any necessary tubing,such as medicament delivery tubing or nasogastric tubing. The tubing mayextend from one or both side(s) of the user's face. In some embodiments,the aforementioned disclosed patient interface and securement systemscan include a dynamic interface to absorb the patient's facialmovements. As will be disclosed, the dynamic interface dampens theeffect of the baby's facial movements on the positioning of the patientinterface about the patient's nose. An example of the dynamic interfaceis disclosed in Applicant's U.S. application Ser. No. 15/028,924, filedon Oct. 16, 2014, that is hereby incorporated by reference.

An example of the attachment mechanism of Applicant's U.S. applicationSer. No. 15/028,924 is hereby reproduced as FIGS. 15A-15C, 16A-16C, and17. In some embodiments, the dynamic interface can incorporate one ormore hinges along the device that reacts to facial movements, bothnatural and forced, and external forces exerted on the interface. Thehinges can minimise the effects of the facial movements and externalforces on the fitment of the interface on the patient's face,particularly on the placement of the prongs in the patient's nares. Asused herein, hinges refers generally to portions on the interface thatare configured to bend in one or more directions. The hinges can beconfigured to bend in a predefined direction or directions, and in someembodiments the hinges can be restricted from bending in certaindirections.

FIGS. 15A-15B illustrate an example of a relaxed facial shape of aninfant and FIG. 15C illustrates a schematic of the geometric shape of adynamic interface 1300 on a relaxed face. FIG. 15A is a front view of aninfant's face and FIG. 15B is a bottom view of the infant's face. FIG.15C is a bottom view of a dynamic interface. The dynamic interface 1300can have one or more hinges 1310. Preferably, the dynamic interface hasa center hinge 1312 disposed between the prongs 1330. As can be noticedby comparing FIGS. 4B and 4C, the plurality of hinges 1310 on theinterface allows the interface 1300 to conform to the general contoursof the patient's face.

FIGS. 16A-B illustrates a front view and a bottom view, respectively, ofan example of a stressed or squeezed facial shape of an infant. FIG. 16Cillustrates a bottom view schematic of the geometric shape of a dynamicinterface 1400 on a squeezed face. The squeezed face approximates, forexample, the contortion of the face when patients lie on the side oftheir faces. As illustrated in FIG. 16C, the hinges 1410 help conformthe interface 1400 to the shape of the contorted face and maintain theposition of the prongs 1430 in the nares of the patient. The dynamicinterface 1400 is particularly helpful in the case of infants who tendto exhibit exaggerated cheek movement.

Each hinge 1410 can be configured to react to an applied force in apredetermined fashion and different hinges can react differentlydepending on their position on the interface. For example, a hinge 1412located in the region between the prongs 1430 may bend downward towardthe lips and/or inward toward the face to form a concave shape whenviewed from the front, while the hinges 1414 adjacent the cheeks of thepatient may bend outward to form a convex shape around the cheeks. Thehinge 1412 can resist movement outwards normal to the face and minimizethe movement of the prongs 1430 out of the nares due to forces appliedlaterally on the device. In some situations, the bending of hinge 1412can be limited by the patient's anatomy. For example, the inward bendingof hinge 1412 can be limited by the philtrum of the patient, which canbeneficially limit the displacement of the prongs 1430. The forcesapplied to the interface may act on the other hinges (e.g., hinges 1414adjacent the cheeks) once the hinge 1412 reaches its limit. Combinationsof hinge types and hinge locations can allow the designer to control howan interface will react in a variety of situations. A hinge may bedesigned to allow for 1, 2 or 3 degrees of motion in any predefineddirection depending on its desired function. Advantageously, aninherently stable interface can be developed that keeps the prongs inthe patients nares under various loading conditions.

Another example of a dynamic nasal interface 1500 is illustrated in FIG.17C. Although the pictured interface is a nasal cannula, the hingingportions could be adapted to support the disclosed adaptor of thepresent application using the same principles, such as by including ahinging extension portion attachable to a patch as discussed above.

For example, FIG. 17 illustrates a nasal interface 1500 having hinges inat least three locations, the bridge hinge 1510 and outer hinges 1512,1514 on either sides of the prongs. The additional hinges of the nasalinterface help stabilize the positions of the prongs 1502 when thecannula is under stress and reduce the displacement distance, helping tokeep the prongs in the nares of the patient and reduce the irritation ofthe nares by the prongs. In some embodiments, the bridge hinge 1510 andouter hinges 1512, 1514 can be configured to be attachable to theaforementioned patch so as to support the disclosed adaptor.

Additional embodiments of dynamic interfaces are further illustrated inFIGS. 8-28 of U.S. application Ser. No. 15/028,924, filed on Oct. 16,2014, of which description is herein incorporated by reference.

In some embodiments, the adaptor 100 can include an inlet port 160 thatcan be fluidly connected an inspiratory tube 6 from a humidificationapparatus and allow fluid flow through the inlet tube 164 in a firstdirection. The inlet tube 164 can include an engagement portion 165 at afirst end that engages with the inspiratory tube 6. In some embodiments,the inlet tube 164 is secured to the inspiratory tube 6 using a securingportion 168. The securing portion 168 can allow the inlet tube 164 to beremovably attached to the inspiratory tube 6. For example, asillustrated in FIGS. 2A and 2B, the securing portion 168 can be a tabthat is secured to a complementary securing portion in the inspiratorytube 6. However, the securing portion 168 can come in any shape andsize, such as a latch, threaded portion, or any locking feature that hasa complementary securing portion on the inspiratory tube 6. In someembodiments, the securing portion 168 can allow the adaptor 100 to bedirectly attached to the respiratory assistance system 1. This can help,for example, to reduce the number of parts in the respiratory assistancesystem 1 as well as reduce the manufacturing costs.

In some embodiments, the outlet port 180 can be configured to receive anexpiratory tube 4 to a pressure regulating device 7. In some examples,the outlet port 180 can be fluidly connected to the respiratoryassistance system 1 to allow fluid flow through the outlet tube 184 in asecond direction. The outlet tube 184 can include an engagement portion165 at a first end that engages with the expiratory tube 4. In someembodiments, the outlet tube 184 can be secured to the expiratory tube 4using a securing portion 188. The securing portion 188 can allow theoutlet tube 184 to be removably attached to the expiratory tube 4. Forexample, as illustrated in FIGS. 3A and 3B, the securing portion 188 canbe a tab that is secured to a complementary securing portion in theexpiratory tube 4. However, the securing portion 188 can come in anyshape and size, such as a latch, threaded portion, or any lockingfeature that has a complementary securing portion on the expiratory tube4. As was discussed with regard to the securing portion 168, in someembodiments, the securing portion 188 can allow the adaptor 100 to bedirectly attached to the respiratory assistance system 1. This can help,for example, to reduce the number of parts in the respiratory assistancesystem 1 as well as reduce the manufacturing costs.

In some embodiments, the inlet tube 164 and the outlet tube 184 areconfigured to extend above and away from the patient. In someembodiments, the “over” and “under” design of the inlet tube 164 and theoutlet tube 184 can help to reduce mass across the patient's face. Insome examples, the inlet tube 164 and the outlet tube 184 can be morerigid so as to able to hold onto its shape without contacting thepatient. The inlet tube 164 and outlet tube 184 can help to reduce theweight perceived by the patient by spreading out or increasing thedistribution of forces from the interface and tubing, reducing patientdiscomfort. In some embodiments, the location of the inlet port 160 andthe outlet port 180 can be alternated.

In some embodiments, the adaptor 100 can include an integrated nozzle122 that is configured to connect with an external device to provide afluid connection with the inside of the housing 120. In some examples,the nozzle 122 can be disposed about another conduit to isolate andrestrict the mixing of the aerosolized material (for example, a drug)with the air flow coming through the inlet tube 164.

As illustrated in FIGS. 2C-2F, in some embodiments, the nozzle 122 canbe disposed about a surfactant tube 114. The surfactant tube 114 canhave a surfactant port 110, an internal surfactant lumen 112, and abifurcated portion 116. In some examples, the surfactant tube 114 canhave a surfactant port 110 at a first end of the surfactant tube 114that is configured to be fluidly connected to the respiratory assistancesystem 1 to allow the delivery of a substance, such as an aerosolizedsurfactant, to the housing 120 and to the patient through the patientinterface 150.

In some embodiments, the surfactant tube 114 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 114 can have a circularcross-section which ensures that the surfactant lumen 112 does not haveany sharp edges so as to reduce deposition within the surfactant lumen112. The surfactant tube 114 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 110 of the surfactanttube 114 is located directly over the nose so as to reduce thedeposition of medicament within the surfactant lumen 112 and ensuresufficient delivery of medicament to the patient.

Turning to FIG. 2G, in some examples, the surfactant tube 114 can have abifurcated portion 116 that allows the surfactant tube 114 to be fluidlyconnected to both nostril lumens 154 of the nasal prongs 152 so as toallow medicament to be delivered through both nostrils of the patient.

The body of the adaptor 100 can be divided into a plurality ofcompartments. FIGS. 2C-2F illustrate the configuration of the adaptor100 and the airflow through the inlet lumen 162, outlet lumen 182,surfactant lumen 112, and the housing 120. The plurality of compartmentswithin the adaptor 100 can reduce premixing of the medicament receivedthrough the surfactant port 110 and the inspiratory gases through theinlet lumen 162 and reduce dilution of the drug by the outgoing gasesthrough the outlet port 180. In some examples, the arrangement of theconduits within the adaptor 100 can help to maximize gas flow to thepatient. For example, inspiratory gases can enter the adaptor 100through the inlet port 160 and flow through the inlet lumen 162 and intothe housing 120. There, the gases can mix with the medicament deliveredfrom the bifurcated portion 116 surfactant tube 114 near the opening ofthe nostril lumens 154. As illustrated in FIG. 2G, there is a gapbetween the end of the bifurcated portion 116 of the surfactant tube 114and the nostril lumens 154 of the patient interface 150 that allowinspiratory gases to flow in. In some embodiments, the expiratory gasescan then exit the patient interface 150 and move around the surfactanttube 114, flow through the outlet lumen 182, and exit the adaptor 100from the outlet port 180.

FIGS. 3A-3H illustrate another embodiment of an adaptor 200. The adaptor200 resembles or is identical to the adaptor 100 in many respects.Accordingly, the numerals used to identify components of the system foradaptor 100 are incremented by one hundred to identify like features ofthe adaptor 200. This number convention generally applies to theremainder of the Figures. Any component disclosed in any embodiment inthis specification can be used in other embodiments.

Turning first to FIGS. 3A and 3B, illustrated is an embodiment of theadaptor 200. Like the adaptor 100, the adaptor 200 can include a housing220 that is fluidly connected to a plurality of conduits to providefluid flow, such as air, and the delivery of aerosolized surfactants tothe patient through the patient interface 250. The adaptor 200 caninclude a housing 220, a plurality of clips 230, an inlet port 260, anoutlet port 280, a surfactant port 210 and a coupling surface 240 forengaging a patient interface 250.

In some examples, as with the housing 120, the housing 220 can include asubstantially hollow cylindrical body. The shape of the housing 220 canbe optimized to reduce resistance to flow within the housing 220. Insome examples, the housing 220 can comprise different shapes, forexample, rectangular, square, hexagonal, or semi-circular. In someembodiments the shape of the housing 220 can minimize volume within thehousing 220. This can reduce dead space—therefore reducing the build-upof carbon dioxide within the housing 220. The housing 220 can be compactso as to reduce the weight and bulk of the housing 220 and improvepatient comfort. As discussed with regard to the adaptor 100, thehousing 220 can be configured to both receive gases through aninspiratory tube and aid the exit of gases through an expiratory tube.

The housing 220 can include a coupling surface 240 at an end of thehousing 220 that is proximate to the patient. As illustrated in FIGS.3A-3B, the coupling surface 340 can be rectangular in cross-section. Thecoupling surface 240 can include a first end that is fluidly connectedwith the housing 220 and a second end that is configured to couple withthe patient interface 250. The second end of the coupling surface 240can allow fluid communication between the housing 220 and the patientinterface 250. In some embodiments, a partial barrier can exist betweenthe housing 220 and the first end of the coupling surface 240. Anorifice can thus maintain fluid communication between the housing 220and the patient interface 250. The orifice can direct the flow of gasestoward the patient interface 250. In some examples, the orifice cancontrol the pressure of the gas flow as it enters the patient interface250.

In some embodiments, the patient interface 250 is similar if notidentical to the patient interface 150 of adaptor 100. As discussed, thepatient interface 250 can be configured to be removably coupled with thecoupling surface 240. In some examples the patient interface 250 can becoupled with the coupling surface 240 using adhesives or mechanicalmechanisms such as snap-fit mechanisms. In some embodiments, the patientinterface 250 can be permanently attached to the coupling surface 240using adhesives, snap-fit mechanisms, or welding techniques. FIGS. 3A-3Hillustrate a patient interface 250 that is transparent so as to allowthe engagement between the coupling surface 240 and the patientinterface 250 to be visualized. The patient interface 250 can include asubstantially hollow complementary region 255 that is configured toreceive the coupling surface 240. As noted above, an embodiment of thecomplementary region of the patient interface can be visualized in FIG.2G. In some embodiments, the coupling surface 240 can be configured toreceive the complementary region 255 of the patient interface 250. Insome embodiments, the patient interface 250 can be permanently coupledwith the adaptor 200. This can provide a fully integrated adaptor whichmay improve the usability of the adaptor 200.

As illustrated in FIGS. 3A-3B, in some examples, the patient interface250 can include nasal prongs 252. In some embodiments, the patientinterface 250 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 200can be adapted for use in a surgical application. The patient interface250 can include a diffuser, trocar, or catheter.

In some embodiments, the adaptor 200 can include clips 230 that arepositioned on first and second sides of the housing 220. As illustratedin FIGS. 3A-3B, the first and second sides of the coupling surface 240can be substantially perpendicular to the first and second ends of thecoupling surface 240. In some embodiments, the clips 230 can beconfigured to be mobile clips. For example, the clip 230 can bepositioned on a slidable and/or rotatable bar or cord. In this way, theposition of the clips 230 can be rotated or altered to simplify theattachment of the patient stabilising mechanism to the adaptor 200. Insome embodiments, the clips 230 can be configured to permanently attachto an interface stabilising mechanism.

As discussed above, in some examples, the clips 230 can engage aremovable attachment that is attached to an interface stabilisingmechanism, such as headgear or a hat or bonnet. As described above, anexample of the removable attachment is illustrated in FIGS. 13A-13B and14A-14D.

In some embodiments, the adaptor 20 can include an inlet port 260 thatcan be fluidly connected an inspiratory tube 6 from a humidificationapparatus and allow fluid flow through the inlet tube 264 in a firstdirection. The inlet tube 264 can include an engagement portion 265 at afirst end that engages with the inspiratory tube 6. In some examples,the engagement portion 265 has a tapered portion that reduces thediameter of the engagement portion 265 to the diameter of the inlet tube264. In some embodiments, the inlet tube 264 is secured to theinspiratory tube 6 using a securing portion 268. The securing portion268 can allow the inlet tube 264 to be removably attached to theinspiratory tube 6. For example, as illustrated in FIGS. 3A and 3B, thesecuring portion 268 can be threaded and configured to engage internalthreading located on a portion of the inspiratory tube 6. However, thesecuring portion 268 can come in any shape and size, such as a tab,latch, or any locking feature that has a complementary securing portionon the inspiratory tube 6. In some embodiments, the securing portion 268can allow the adaptor 200 to be directly attached to the respiratoryassistance system 1. This can help, for example, to reduce the number ofparts in the respiratory assistance system 1 as well as reduce themanufacturing costs.

In some embodiments, the outlet port 280 can be configured to receive anexpiratory tube 4 to a pressure regulating device 7. In some examples,the outlet port 280 can be fluidly connected to the respiratoryassistance system 1 to allow fluid flow through the outlet tube 284 in asecond direction. The outlet tube 284 can include an engagement portion265 at a first end that engages with the expiratory tube 4. In someembodiments, the outlet tube 284 can be secured to the expiratory tube 4using a securing portion 288. The securing portion 488 can allow theoutlet tube 284 to be removably attached to the expiratory tube 4. Forexample, as illustrated in FIGS. 3A and 3B, the securing portion 288 canbe threaded and configured to engage internal threading located on aportion of the expiratory tube 4. However, the securing portion 288 cancome in any shape and size, such as a latch, threaded portion, or anylocking feature that has a complementary securing portion on theexpiratory tube 4. As was discussed with regard to the securing portion268, in some embodiments, the securing portion 288 can allow the adaptor200 to be directly attached to the respiratory assistance system 1. Thiscan help, for example, to reduce the number of parts in the respiratoryassistance system 1 as well as reduce the manufacturing costs.

In some embodiments, the inlet tube 264 and the outlet tube 284 areconfigured to extend above and away from the patient. As illustrated inFIGS. 3A-3B, the engagement portion 265 and the engagement portion 285are located one above the other, with the engagement portion 265 andengagement portion 285 parallel to each other. In some embodiments, theinlet tube 264 can have a curved portion from the engagement portion 265to the body of the housing 220. In some embodiments, the curvedstructure of the inlet tube 264 can help to reduce sharp turns thatcould potentially cause turbulence and condensation of the surfactant.In some examples, the inlet tube 264 and the outlet tube 284 can be morerigid so as to able to hold onto its shape without contacting thepatient. The inlet tube 264 and outlet tube 284 can help to reduce theweight perceived by the patient by spreading out or increasing thedistribution of forces from the interface and tubing, reducing patientdiscomfort. In some embodiments, the location of the inlet port 260 andthe outlet port 280 can be alternated. In some examples, the curvedinlet tube 264 can be configured to introduce medication as directlyinto the patient as possible through the nostril lumens 254.

As with the adaptor 100, in some embodiments, the adaptor 200 caninclude an integrated nozzle 222 that is configured to connect with anexternal device to provide a fluid connection with the inside of thehousing 220. In some examples, the nozzle 222 can be disposed aboutanother conduit to isolate and restrict the mixing of the aerosolizedmaterial (for example, a drug) with the air flow coming through theinlet tube 264.

As illustrated in FIGS. 3C-3H, in some embodiments, the nozzle 222 canbe disposed about a surfactant tube 214. The surfactant tube 214 canhave a surfactant port 210, an internal surfactant lumen 212, and abifurcated portion 216. In some examples, the surfactant tube 214 canhave a surfactant port 210 at a first end of the surfactant tube 214that is configured to be fluidly connected to the respiratory assistancesystem 1 to allow the delivery of a substance, such as an aerosolizedsurfactant, to the housing 220 and to the patient through the patientinterface 250.

In some embodiments, the surfactant tube 214 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 214 can have a circularcross-section which ensures that the surfactant lumen 212 does not haveany sharp edges so as to reduce deposition within the surfactant lumen212. The surfactant tube 214 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 210 of the surfactanttube 214 is located directly over the nose so as to reduce thedeposition of medicament within the surfactant lumen 212 and ensuresufficient delivery of medicament to the patient.

As discussed above with regard to FIG. 2G, in some examples, thesurfactant tube 214 can have a bifurcated portion 216 that allows thesurfactant tube 214 to be fluidly connected to both nostril lumens 254of the nasal prongs 252 so as to allow medicament to be deliveredthrough both nostrils of the patient.

The body of the adaptor 200 can be divided into a plurality ofcompartments. FIGS. 3C-3H illustrate the configuration of the adaptor200 and the airflow through the inlet lumen 262, outlet lumen 282,surfactant lumen 212, and the housing 220. The plurality of compartmentswithin the adaptor 200 can reduce premixing of the medicament receivedthrough the surfactant port 210 and the inspiratory gases through theinlet lumen 262 and reduce dilution of the drug by the outgoing gasesthrough the outlet port 280. In some examples, the arrangement of theconduits within the adaptor 200 can help to maximize gas flow to thepatient. For example, inspiratory gases can enter the adaptor 200through the inlet port 260 and flow through the inlet lumen 262 and intothe housing 220. There, the gases can mix with the medicament deliveredfrom the bifurcated portion 216 surfactant tube 214 near the opening ofthe nostril lumens 254. Similar to the surfactant tube 114 in FIG. 2G,there is a gap between the end of the bifurcated portion 216 of thesurfactant tube 214 and the nostril lumens 254 of the patient interface250 that allow inspiratory gases to flow in. In some embodiments, theexpiratory gases can then exit the patient interface 250 and move aroundthe surfactant tube 214, flow through the outlet lumen 282, and exit theadaptor 200 from the outlet port 280.

FIGS. 4A-4G illustrate another embodiment of an adaptor 300. The adaptor300 resembles or is identical to the adaptor 100 in many respects.Accordingly, the numerals used to identify components of the system foradaptor 100 are incremented by one hundred to identify like features ofthe adaptor 300. This number convention generally applies to theremainder of the Figures. Any component disclosed in any embodiment inthis specification can be used in other embodiments.

Turning first to FIGS. 4A and 4B, illustrated is an embodiment of theadaptor 300. Like the adaptor 100, the adaptor 300 can include a housing320 that is fluidly connected to a plurality of conduits to providefluid flow, such as air, and the delivery of aerosolized surfactants tothe patient through the patient interface 350. The adaptor 300 caninclude a housing 320, a plurality of clips 330, an inlet port 360, anoutlet port 380, a pressure port 370, a surfactant port 310 and acoupling surface 340 for engaging a patient interface 350.

In some examples, as with the housing 120, the housing 320 can include asubstantially hollow cylindrical body. The shape of the housing 320 canbe optimized to reduce resistance to flow within the housing 320. Insome examples, the housing 320 can comprise different shapes, forexample, rectangular, square, hexagonal, or semi-circular. In someembodiments the shape of the housing 320 can minimize volume within thehousing 320. This can reduce dead space—therefore reducing the build-upof carbon dioxide within the housing 320. The housing 320 can be compactso as to reduce the weight and bulk of the housing 320 and improvepatient comfort. As discussed with regard to the adaptor 100, thehousing 320 can be configured to both receive gases through aninspiratory tube and aid the exit of gases through an expiratory tube.

The housing 320 can include a coupling surface 340 at an end of thehousing 320 that is proximate to the patient. As illustrated in FIGS.4A-4B, the coupling surface 340 can be rectangular in cross-section. Thecoupling surface 340 can include a first end that is fluidly connectedwith the housing 320 and a second end that is configured to couple withthe patient interface 350. The second end of the coupling surface 340can allow fluid communication between the housing 320 and the patientinterface 350. In some embodiments, a partial barrier can exist betweenthe housing 320 and the first end of the coupling surface 340. Anorifice can thus maintain fluid communication between the housing 320and the patient interface 350. The orifice can direct the flow of gasestoward the patient interface 350. In some examples, the orifice cancontrol the pressure of the gas flow as it enters the patient interface350.

In some embodiments, the patient interface 350 is similar if notidentical to the patient interface 150 of adaptor 100. As discussed, thepatient interface 350 can be configured to be removably coupled with thecoupling surface 340. In some examples the patient interface 350 can becoupled with the coupling surface 340 using adhesives or mechanicalmechanisms such as snap-fit mechanisms. In some embodiments, the patientinterface 350 can be permanently attached to the coupling surface 340using adhesives, snap-fit mechanisms, or welding techniques. FIGS. 4A-4Gillustrate a patient interface 350 that is transparent so as to allowthe engagement between the coupling surface 340 and the patientinterface 350 to be visualized. The patient interface 350 can include asubstantially hollow complementary region 355 that is configured toreceive the coupling surface 340. As noted above, an embodiment of thecomplementary region of the patient interface can be visualized in FIG.2G. In some embodiments, the coupling surface 340 can be configured toreceive the complementary region 355 of the patient interface 250. Insome embodiments, the patient interface 350 can be permanently coupledwith the adaptor 300. This can provide a fully integrated adaptor whichmay improve the usability of the adaptor 300.

As illustrated in FIGS. 4A-4B, in some examples, the patient interface350 can include nasal prongs 352. In some embodiments, the patientinterface 350 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 300can be adapted for use in a surgical application. The patient interface350 can include a diffuser, trocar, or catheter.

In some embodiments, the adaptor 300 can include clips 330 that arepositioned on first and second sides of the housing 320. As illustratedin FIGS. 4A-4B, the first and second sides of the coupling surface 340can be substantially perpendicular to the first and second ends of thecoupling surface 340. In some embodiments, the clips 330 can beconfigured to be mobile clips. For example, the clip 330 can bepositioned on a slidable and/or rotatable bar or cord. In this way, theposition of the clips 330 can be rotated or altered to simplify theattachment of the patient stabilising mechanism to the adaptor 300. Insome embodiments, the clips 330 can be configured to permanently attachto an interface stabilising mechanism.

As discussed above, in some examples, the clips 330 can engage aremovable attachment that is attached to an interface stabilisingmechanism, such as headgear or a hat or bonnet. As described above, anexample of the removable attachment is illustrated in FIGS. 13A and 13B.

In some embodiments, the adaptor 300 can include an inlet port 360 thatcan be fluidly connected an inspiratory tube 6 from a humidificationapparatus and allow fluid flow through the inlet tube 364 in a firstdirection. In some embodiments, the outlet port 380 can be configured toreceive an expiratory tube 4. In some examples, the outlet port 380 canbe fluidly connected to the respiratory assistance system 1 to allowfluid flow through the outlet tube 384 in a second direction.

In some embodiments, the inlet tube 364 and the outlet tube 384 areconfigured to extend above and away from the patient. In someembodiments, the “over” and “under” design of the inlet tube 364 and theoutlet tube 384 can help to reduce mass across the patient's face. Insome examples, the inlet tube 364 and the outlet tube 384 can be morerigid so as to able to hold onto its shape without contacting thepatient. The inlet tube 364 and outlet tube 384 can help to reduce theweight perceived by the patient by spreading out or increasing thedistribution of forces from the interface and tubing, reducing patientdiscomfort. In some embodiments, the location of the inlet port 360 andthe outlet port 380 can be alternated.

In some examples, the adaptor 300 can include a pressure tube 374 with apressure port 370 and a pressure lumen 372 that is fluidly connected tothe housing 320. As illustrated in FIGS. 4A-4B, the pressure tube 374 islocated between the inlet tube 364 and outlet tube 384 and the pressuretube 374 is fluidly connected to a pressure line which is fluidlyconnected to the pressure regulating device 7.

As with the adaptor 100, in some embodiments, the adaptor 300 caninclude an integrated nozzle 322 that is configured to connect with anexternal device to provide a fluid connection with the inside of thehousing 320. In some examples, the nozzle 322 can be fluidly connectedto another conduit to isolate and restrict the mixing of the aerosolizedmaterial (for example, a drug) with the air flow coming through theinlet tube 364.

As illustrated in FIGS. 4C-4G, in some embodiments, the nozzle 322 canbe fluidly connected to a surfactant tube 314. The surfactant tube 314can have a surfactant port 310, an internal surfactant lumen 312, and abifurcated portion 316. In some examples, the surfactant tube 314 canhave a surfactant port 310 at a first end of the surfactant tube 314that is configured to be fluidly connected to the respiratory assistancesystem 1 to allow the delivery of a substance, such as an aerosolizedsurfactant, through the housing 320 and to the patient through thepatient interface 350.

In some embodiments, the surfactant tube 314 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 314 can have a circularcross-section which ensures that the surfactant lumen 312 does not haveany sharp edges so as to reduce deposition within the surfactant lumen312. The surfactant tube 314 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 310 of the surfactanttube 314 is located directly over the nose so as to reduce thedeposition of medicament within the surfactant lumen 312 and ensuresufficient delivery of medicament to the patient.

The body of the adaptor 300 can be divided into a plurality ofcompartments. FIGS. 4C-4G illustrate the configuration of the adaptor300 and the airflow through the inlet lumen 362, outlet lumen 382,surfactant lumen 312, pressure lumen 372, and the housing 320. Theplurality of compartments within the adaptor 300 can reduce premixing ofthe medicament received through the surfactant port 310 and theinspiratory gases through the inlet lumen 362 and reduce dilution of thedrug by the outgoing gases through the outlet port 380. In someexamples, the arrangement of the conduits within the adaptor 300 canhelp to maximize gas flow to the patient. For example, inspiratory gasescan enter the adaptor 300 through the inlet port 360 and flow throughthe inlet lumen 362 and into the housing 320. There, the gases can mixwith the medicament delivered from the bifurcated portion 316 surfactanttube 314 near the opening of the nostril lumens 354. As illustrated inFIG. 4C, there is a gap between the end of the surfactant tube 314 andthe nostril lumens 354 of the patient interface 350 that allowinspiratory gases to flow in. In some embodiments, the expiratory gasescan then exit the patient interface 350 and move around the surfactanttube 314, flow through the outlet lumen 382, and exit the adaptor 300from the outlet port 380.

FIGS. 5A-5G illustrate another embodiment of an adaptor 400. The adaptor400 resembles or is identical to the adaptor 100 in many respects.Accordingly, the numerals used to identify components of the system foradaptor 100 are incremented by one hundred to identify like features ofthe adaptor 400. This number convention generally applies to theremainder of the Figures. Any component disclosed in any embodiment inthis specification can be used in other embodiments.

Turning first to FIGS. 5A and 5B, illustrated is an embodiment of theadaptor 400. Like the adaptor 100, the adaptor 400 can include a housing420 that is fluidly connected to a plurality of conduits to providefluid flow, such as air, and the delivery of aerosolized surfactants tothe patient through the patient interface 450. The adaptor 400 caninclude a housing 420, a plurality of clips 430, an inlet port 460, anoutlet port 480, a pressure port 470, a surfactant port 410 and acoupling surface 440 for engaging a patient interface 450. In someembodiments, the adaptor 400 is configured to have an oval tube orientedto present the smallest possible trunk width between the patient's (forexample, the infant) eyes while maintaining a sufficient cross-sectionto provide sufficient air flow.

In some examples, as with the housing 120, the housing 420 can include asubstantially hollow cylindrical body. The shape of the housing 420 canbe optimized to reduce resistance to flow within the housing 420. Insome examples, the housing 420 can comprise different shapes, forexample, rectangular, square, hexagonal, or semi-circular. In someembodiments the shape of the housing 420 can minimize volume within thehousing 420. This can reduce dead space—therefore reducing the build-upof carbon dioxide within the housing 420. The housing 420 can be compactso as to reduce the weight and bulk of the housing 420 and improvepatient comfort. As discussed with regard to the adaptor 100, thehousing 420 can be configured to both receive gases through aninspiratory tube and aid the exit of gases through an expiratory tube.

The housing 420 can include a coupling surface 440 at an end of thehousing 420 that is proximate to the patient. As illustrated in FIGS.5A-5B, the coupling surface 440 can be rectangular in cross-section. Thecoupling surface 440 can include a first end that is fluidly connectedwith the housing 420 and a second end that is configured to couple withthe patient interface 450. The second end of the coupling surface 440can allow fluid communication between the housing 420 and the patientinterface 450. In some embodiments, a partial barrier can exist betweenthe housing 420 and the first end of the coupling surface 440. Anorifice can thus maintain fluid communication between the housing 420and the patient interface 450. The orifice can direct the flow of gasestoward the patient interface 450. In some examples, the orifice cancontrol the pressure of the gas flow as it enters the patient interface450.

In some embodiments, the patient interface 450 is similar if notidentical to the patient interface 150 of adaptor 100. As discussed, thepatient interface 450 can be configured to be removably coupled with thecoupling surface 440. In some examples the patient interface 450 can becoupled with the coupling surface 440 using adhesives or mechanicalmechanisms such as snap-fit mechanisms. In some embodiments, the patientinterface 450 can be permanently attached to the coupling surface 440using adhesives, snap-fit mechanisms, or welding techniques. FIGS. 5A-5Gillustrate a patient interface 450 that is transparent so as to allowthe engagement between the coupling surface 440 and the patientinterface 450 to be visualized. The patient interface 450 can include asubstantially hollow complementary region 455 that is configured toreceive the coupling surface 440. In some embodiments, the couplingsurface 440 can be configured to receive the complementary region 455 ofthe patient interface 450. In some embodiments, the patient interface450 can be permanently coupled with the adaptor 400. This can provide afully integrated adaptor which may improve the usability of the adaptor400.

As illustrated in FIGS. 5A-5B, in some examples, the patient interface450 can include nasal prongs 452. In some embodiments, the patientinterface 450 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 400can be adapted for use in a surgical application. The patient interface450 can include a diffuser, trocar, or catheter.

In some embodiments, the adaptor 400 can include clips 430 that arepositioned on first and second sides of the housing 420. As illustratedin FIGS. 5A-5B, the first and second sides of the coupling surface 440can be substantially perpendicular to the first and second ends of thecoupling surface 440. In some embodiments, the clips 430 can beconfigured to be mobile clips. For example, the clip 430 can bepositioned on a slidable and/or rotatable bar or cord. In this way, theposition of the clips 430 can be rotated or altered to simplify theattachment of the patient stabilising mechanism to the adaptor 400. Insome embodiments, the clips 330 can be configured to permanently attachto an interface stabilising mechanism.

As discussed above, in some examples, the clips 430 can engage aremovable attachment that is attached to an interface stabilisingmechanism, such as headgear or a hat or bonnet. As described above, anexample of the removable attachment is illustrated in FIGS. 13A and 13B.

In some embodiments, the adaptor 400 can include a plurality of conduitsthat act as the inlet and outlet of air flow that are located adjacentto each. In some embodiments, the plurality of conduits runs parallel toeach other. As illustrated in FIGS. 5A and 5B, as the plurality ofconduits are located adjacent to each other, the inlet port 460 and theoutlet port 480 are interchangeable and can be located on either side ofthe housing 420.

In some examples, the adaptor 400 can include an inlet port 460 that canbe fluidly connected to an inspiratory tube 6 from a humidificationapparatus and allow fluid flow through the inlet tube 464 in a firstdirection. In some embodiments, the inlet tube 464 can include anengagement portion 465 at a first end that engages with the inspiratorytube 6. In some embodiments, the inlet tube 464 is secured to theinspiratory tube 6 using a securing portion 468. The securing portion468 can allow the inlet tube 464 to be removably attached to theinspiratory tube 6. For example, as illustrated in FIGS. 4A and 4B, thesecuring portion 468 can be threaded and configured to engage internalthreading located on a portion of the inspiratory tube 6. However, thesecuring portion 468 can come in any shape and size, such as a tab,latch, or any locking feature that has a complementary securing portionon the inspiratory tube 6. In some embodiments, the securing portionsecuring portion 468 can allow the adaptor 400 to be directly attachedto the respiratory assistance system 1. This can help, for example, toreduce the number of parts in the respiratory assistance system 1 aswell as reduce the manufacturing costs.

In some embodiments, the outlet port 480 can be configured to receive anexpiratory tube 4. In some examples, the outlet port 480 can be fluidlyconnected to the respiratory assistance system 1 to allow fluid flowthrough the outlet tube 484 in a second direction. The outlet tube 484can include an engagement portion 465 at a first end that engages withthe expiratory tube 4. In some embodiments, the outlet tube 484 can besecured to the expiratory tube 4 using a securing portion 488. Thesecuring portion 488 can allow the outlet tube 484 to be removablyattached to the expiratory tube 4. For example, as illustrated in FIGS.5A and 5B, the securing portion 488 can be threaded and configured toengage internal threading located on a portion of the expiratory tube 4.However, the securing portion 488 can come in any shape and size, suchas a latch, threaded portion, or any locking feature that has acomplementary securing portion on the expiratory tube 4. As wasdiscussed with regard to the securing portion 468, in some embodiments,the securing portion 488 can allow the adaptor 400 to be directlyattached to the respiratory assistance system 1. This can help, forexample, to reduce the number of parts in the respiratory assistancesystem 1 as well as reduce the manufacturing costs.

In some examples, the inlet tube 464 and the outlet tube 484 areconfigured to extend above and away from the patient. As with theadaptor 300, the adaptor 400 retains the narrow body of the “over” and“under” design, but, as mentioned above, the connectors are nowside-by-side so connections are interchangeable. As discussed, withregard to the adaptor 300, this design of the inlet tube 464 and theoutlet tube 484 can help to reduce the mass across the patient's face.In some examples, the inlet tube 464 and the outlet tube 484 can be morerigid so as to be able to hold onto its shape without contacting thepatient. The inlet tube 464 and the outlet tube 484 can help to reducethe weight perceived by the patient by spreading out or increasing thedistribution of forces from the interface and tubing, reducing patientdiscomfort. In some embodiments, the location of the inlet port 460 andthe outlet port 480 can be alternated.

In some examples, the adaptor 400 can include a pressure tube 474 with apressure port 470 and a pressure lumen 472 that is fluidly connected tothe housing 420. As illustrated in FIG. 5C, the pressure tube 474extends above the pair of conduits (the inlet port 460 and the outletport 480) such that the pressure port 470 is directed away from the faceof the patient. The pressure tube 474 can generally extend verticallybetween the inlet port 460 and outlet port 480 before making anapproximately right angle turn towards the housing 420 such that thepressure lumen 472 extends between the inlet port 460 and outlet port480 on the side of the adaptor 400 closest to the patient. In someembodiments, the pressure lumen 472 extends towards the housing 420 suchthat the pressure port 470 and pressure lumen 472 are fluidly connectedto the housing 420. In some embodiments, the pressure tube 474 isfluidly connected to a pressure line which is fluidly connected to thepressure regulating device 7.

As with the adaptor 100, in some embodiments, the adaptor 400 caninclude nozzle 422 that is configured to connect with an external deviceto provide a fluid connection with the inside of the housing 420. Insome examples, the nozzle 422 can be fluidly connected to anotherconduit to isolate and restrict the mixing of the aerosolized material(for example, a drug) with the air flow coming through the inlet tube464.

As illustrated in FIGS. 5C-5G, in some embodiments, the nozzle 422 canbe fluidly connected to a surfactant tube 414. The surfactant tube 414can have a surfactant port 410 and a surfactant lumen 412. As shown inFIG. 5C, the surfactant port 410 is located closer to the patient'sforehead and is closer to the housing 420 than the pressure port 470. Insome embodiments, the surfactant tube 414 extends above the pair ofconduits (the inlet port 460 and the outlet port 480) such that thesurfactant port 410 is directed away from the face of the patient. Thesurfactant tube 414 can make an approximately right turn towards thehousing 420. In some examples, the surfactant lumen 412 can extendtowards the housing 420 between the inlet port 460 and pressure port 470such that the surfactant tube 414 is on the side of the adaptor 400furthest away from the patient. In some embodiments, the surfactantlumen 412 extends towards the housing 420 such that the surfactant port410 and the surfactant lumen 412 are fluidly connected to the housing420.

In some examples, the surfactant tube 414 can have a surfactant port 410at a first end of the surfactant tube 414 that is configured to befluidly connected to the respiratory assistance system 1 to allow thedelivery of a substance, such as an aerosolized surfactant, through thehousing 420 and to the patient through the patient interface 450.

In some embodiments, the surfactant tube 414 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 414 can have a circularcross-section which ensures that the surfactant lumen 412 does not haveany sharp edges so as to reduce deposition within the surfactant lumen412. The surfactant tube 414 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 410 of the surfactanttube 414 is located directly over the nose so as to reduce thedeposition of medicament within the surfactant lumen 412 and ensuresufficient delivery of medicament to the patient.

The body of the adaptor 400 can be divided into a plurality ofcompartments. FIGS. 5C-5G illustrate the configuration of the adaptor400 and the airflow through the tubular body 490, surfactant lumen 412,pressure lumen 472, and the housing 420. As illustrated in FIGS. 5C-5G,the tubular body 490 can be divided into an inlet lumen 462 and anoutlet lumen 482. The plurality of compartments within the adaptor 400can reduce premixing of the medicament received through the surfactantport 410 and the inspiratory gases through the inlet lumen 462 andreduce dilution of the drug by the outgoing gases through the outletport 480. In some examples, the arrangement of the conduits within theadaptor 400 can help to maximize gas flow to the patient. For example,inspiratory gases can enter the adaptor 400 through the inlet port 460and flow through the inlet lumen 462 and into the housing 420. There,the gases can mix with the medicament delivered from the surfactant tube414 near the opening of the nostril lumens (not pictured). Asillustrated in FIG. 5C, there is a gap between the end of the surfactanttube 414 and the nostril lumens (not illustrated) of the patientinterface 450 that allow inspiratory gases to flow in. In someembodiments, the expiratory gases can then exit the patient interface450 and move around the surfactant tube 414, flow through the outletlumen 482, and exit the adaptor 400 from the outlet port 480.

FIGS. 6A-6I illustrate another embodiment of an adaptor 500. The adaptor500 resembles or is identical to the adaptor 100 in many respects.Accordingly, the numerals used to identify components of the system foradaptor 100 are incremented by one hundred to identify like features ofthe adaptor 500. This number convention generally applies to theremainder of the Figures. Any component disclosed in any embodiment inthis specification can be used in other embodiments. In someembodiments, the adaptor 500 is configured to have an oval tube orientedto present the smallest possible trunk width between the patient's (forexample, the infant) eyes while maintaining a sufficient cross-sectionto provide sufficient air flow.

Turning first to FIGS. 6A and 6B, illustrated is an embodiment of theadaptor 500. Like the adaptor 100, the adaptor 500 can include a housing520 that is fluidly connected to a plurality of conduits to providefluid flow, such as air, and the delivery of aerosolized surfactants tothe patient through the patient interface 550. The adaptor 500 caninclude a housing 520, a plurality of clips 530, an inlet port 560, anoutlet port 580, a pressure port 570, a surfactant port 510 and acoupling surface 540 for engaging a patient interface 550.

In some examples, as with the housing 120, the housing 520 can include asubstantially hollow cylindrical body. The shape of the housing 520 canbe optimized to reduce resistance to flow within the housing 520. Insome examples, the housing 520 can comprise different shapes, forexample, rectangular, square, hexagonal, or semi-circular. In someembodiments the shape of the housing 520 can minimize volume within thehousing 520. This can reduce dead space—therefore reducing the build-upof carbon dioxide within the housing 520. The housing 520 can be compactso as to reduce the weight and bulk of the housing 520 and improvepatient comfort. As discussed with regard to the adaptor 100, thehousing 520 can be configured to both receive gases through aninspiratory tube and aid the exit of gases through an expiratory tube.

The housing 520 can include a coupling surface 540 at an end of thehousing 520 that is proximate to the patient. As illustrated in FIGS.6A-6B, the coupling surface 540 can be rectangular in cross-section. Thecoupling surface 540 can include a first end that is fluidly connectedwith the housing 520 and a second end that is configured to couple withthe patient interface 550. The second end of the coupling surface 540can allow fluid communication between the housing 520 and the patientinterface 550. In some embodiments, a partial barrier can exist betweenthe housing 520 and the first end of the coupling surface 540. Anorifice can thus maintain fluid communication between the housing 520and the patient interface 550. The orifice can direct the flow of gasestoward the patient interface 550. In some examples, the orifice cancontrol the pressure of the gas flow as it enters the patient interface550.

In some embodiments, the patient interface 550 is similar if notidentical to the patient interface 150 of adaptor 100. As discussed, thepatient interface 550 can be configured to be removably coupled with thecoupling surface 540. In some examples the patient interface 550 can becoupled with the coupling surface 540 using adhesives or mechanicalmechanisms such as snap-fit mechanisms. In some embodiments, the patientinterface 550 can be permanently attached to the coupling surface 540using adhesives, snap-fit mechanisms, or welding techniques. FIGS. 6A-6Iillustrate a patient interface 550 that is transparent so as to allowthe engagement between the coupling surface 540 and the patientinterface 550 to be visualized. The patient interface 550 can include asubstantially hollow complementary region 555 that is configured toreceive the coupling surface 540. In some embodiments, the couplingsurface 540 can be configured to receive the complementary region 555 ofthe patient interface 550. In some embodiments, the patient interface550 can be permanently coupled with the adaptor 500. This can provide afully integrated adaptor which may improve the usability of the adaptor500.

As illustrated in FIGS. 6A-6B, in some examples, the patient interface550 can include nasal prongs 552. In some embodiments, the patientinterface 550 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 500can be adapted for use in a surgical application. The patient interface550 can include a diffuser, trocar, or catheter.

In some embodiments, the adaptor 500 can include clips 530 that arepositioned on first and second sides of the housing 520. As illustratedin FIGS. 6A-6B, the first and second sides of the coupling surface 540can be substantially perpendicular to the first and second ends of thecoupling surface 540. In some embodiments, the clips 530 can beconfigured to be mobile clips. For example, the clip 530 can bepositioned on a slidable and/or rotatable bar or cord. In this way, theposition of the clips 530 can be rotated or altered to simplify theattachment of the patient stabilising mechanism to the adaptor 500. Insome embodiments, the clips 530 can be configured to permanently attachto an interface stabilising mechanism.

As discussed above, in some examples, the clips 530 can engage aremovable attachment that is attached to an interface stabilisingmechanism, such as headgear or a hat or bonnet. As described above, anexample of the removable attachment is illustrated in FIGS. 13A and 13B.

In some embodiments, the adaptor 500 can include a plurality of conduitsthat act as the inlet and outlet of air flow that are located adjacentto each. In some embodiments, the plurality of conduits runs parallel toeach other. As illustrated in FIGS. 6A and 6B, as the plurality ofconduits are located adjacent to each other, the inlet port 560 and theoutlet port 580 are interchangeable and can be located on either side ofthe housing 520.

In some examples, the adaptor 500 can include an inlet port 560 that canbe fluidly connected to an inspiratory tube 6 from a humidificationapparatus and allow fluid flow through the inlet tube 564 in a firstdirection. In some embodiments, the inlet tube 564 can include anengagement portion 565 at a first end that engages with the inspiratorytube 6. In some embodiments, the inlet tube 564 is secured to theinspiratory tube 6 using a securing portion 568. The securing portion568 can allow the inlet tube 564 to be removably attached to theinspiratory tube 6. For example, as illustrated in FIGS. 6A and 6B, thesecuring portion 568 can be threaded and configured to engage internalthreading located on a portion of the inspiratory tube 6. However, thesecuring portion 568 can come in any shape and size, such as a tab,latch, or any locking feature that has a complementary securing portionon the inspiratory tube 6. In some embodiments, the securing portion 568can allow the adaptor 500 to be directly attached to the respiratoryassistance system 1. This can help, for example, to reduce the number ofparts in the respiratory assistance system 1 as well as reduce themanufacturing costs.

In some embodiments, the outlet port 580 can be configured to receive anexpiratory tube 4. In some examples, the outlet port 580 can be fluidlyconnected to the respiratory assistance system 1 to allow fluid flowthrough the outlet tube 584 in a second direction. The outlet tube 584can include an engagement portion 565 at a first end that engages withthe expiratory tube 4. In some embodiments, the outlet tube 584 can besecured to the expiratory tube 4 using a securing portion 588. Thesecuring portion 588 can allow the outlet tube 584 to be removablyattached to the expiratory tube 4. For example, as illustrated in FIGS.6A and 6B, the securing portion 588 can be threaded and configured toengage internal threading located on a portion of the expiratory tube 4.However, the securing portion 588 can come in any shape and size, suchas a latch, threaded portion, or any locking feature that has acomplementary securing portion on the expiratory tube 4. As wasdiscussed with regard to the securing portion 568, in some embodiments,the securing portion 588 can allow the adaptor 500 to be directlyattached to the respiratory assistance system 1. This can help, forexample, to reduce the number of parts in the respiratory assistancesystem 1 as well as reduce the manufacturing costs.

In some examples, the inlet tube 564 and the outlet tube 584 areconfigured to extend above and away from the patient. As with theadaptor 300 and adaptor 400, the adaptor 500 retains the narrow body ofthe “over” and “under” design, but, as mentioned above, the connectorsare now side-by-side so connections are interchangeable. As discussed,with regard to the adaptor 500, this design of the inlet tube 564 andthe outlet tube 584 can help to reduce the mass across the patient'sface. In some examples, the inlet tube 564 and the outlet tube 584 canbe more rigid so as to be able to hold onto its shape without contactingthe patient. The inlet tube 564 and the outlet tube 584 can help toreduce the weight perceived by the patient by spreading out orincreasing the distribution of forces from the interface and tubing,reducing patient discomfort. In some embodiments, the location of theinlet port 560 and the outlet port 580 can be alternated.

In some examples, the adaptor 500 can include a pressure tube 574 with apressure port 570 and a pressure lumen 572 that is fluidly connected tothe housing 520. As illustrated in FIG. 6C, the pressure tube 574extends below the pair of conduits (the inlet port 560 and the outletport 580) such that the pressure port 570 is directed towards the faceof the patient. In some embodiments, the pressure port 570 is adjacentto and faces the patient's face. In order to protect the patient's face,the pressure port 570 can protrude into and be retained into a foamblock.

The disclosed adaptors can be retained and stabilized on the patient'shead. Examples of these retention and stabilization structures aredisclosed in Applicant's U.S. application Ser. No. 10/242,903, filed onSep. 13, 2002, that is hereby incorporated by reference.

The pressure tube 574 can generally extend vertically between the inletport 560 and outlet port 580 before making an approximately right angleturn towards the housing 520 such that the pressure lumen 572 extendsbetween the inlet port 560 and outlet port 580 on the side of theadaptor 500 closest to the patient. In some embodiments, the pressurelumen 572 extends towards the housing 520 such that the pressure port570 and pressure lumen 572 are fluidly connected to the housing 520. Insome embodiments, the pressure tube 574 is fluidly connected to apressure line which is fluidly connected to the pressure regulatingdevice 7.

As with the adaptor 100, in some embodiments, the adaptor 500 caninclude nozzle 522 that is configured to connect with an external deviceto provide a fluid connection with the inside of the housing 520. Insome examples, the nozzle 522 can be fluidly connected to anotherconduit to isolate and restrict the mixing of the aerosolized material(for example, a drug) with the air flow coming through the inlet tube564.

As illustrated in FIGS. 6C-6I, in some embodiments, the nozzle 522 canbe fluidly connected to a surfactant tube 514. The surfactant tube 514can have a surfactant port 510 and a surfactant lumen 512. As shown inFIG. 6C, the surfactant port 510 is located closer to the patient'sforehead and is closer to the housing 520 than the pressure port 570. Insome embodiments, the surfactant tube 514 extends above the pair ofconduits (the inlet port 560 and the outlet port 580) such that thesurfactant port 510 is directed away from the face of the patient. Thesurfactant tube 514 can make an approximately right turn towards thehousing 520. In some examples, the surfactant lumen 512 can extendtowards the housing 520 between the inlet port 560 and pressure port 570such that the surfactant tube 514 is on the side of the adaptor 500furthest away from the patient. In some embodiments, the surfactantlumen 512 extends towards the housing 520 such that the surfactant port510 and the surfactant lumen 512 are fluidly connected to the housing520.

In some examples, the surfactant tube 514 can have a surfactant port 510at a first end of the surfactant tube 514 that is configured to befluidly connected to the respiratory assistance system 1 to allow thedelivery of a substance, such as an aerosolized surfactant, through thehousing 520 and to the patient through the patient interface 550.

In some embodiments, the surfactant tube 514 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 514 can have a circularcross-section which ensures that the surfactant lumen 512 does not haveany sharp edges so as to reduce deposition within the surfactant lumen512. The surfactant tube 514 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 510 of the surfactanttube 514 is located directly over the nose so as to reduce thedeposition of medicament within the surfactant lumen 512 and ensuresufficient delivery of medicament to the patient.

In contrast to the adaptor 400, the surfactant port 510 and the pressureport 570 extend from opposing sides of the adaptor 500. The surfactantport 510 and the pressure port 570 directing from opposing side of theadaptor 500 helps to avoid confusion and entanglement of the surfactantport 510 and the pressure port 570.

The body of the adaptor 500 can be divided into a plurality ofcompartments. FIGS. 6C-6I illustrate the configuration of the adaptor500 and the airflow through the tubular body 590, surfactant lumen 512,pressure lumen 572, and the housing 520. As illustrated in FIGS. 6C-6I,the tubular body 590 can be divided into an inlet lumen 562 and anoutlet lumen 582. The plurality of compartments within the adaptor 500can reduce premixing of the medicament received through the surfactantport 510 and the inspiratory gases through the inlet lumen 562 andreduce dilution of the drug by the outgoing gases through the outletport 580. In some examples, the arrangement of the conduits within theadaptor 500 can help to maximize gas flow to the patient. For example,inspiratory gases can enter the adaptor 500 through the inlet port 560and flow through the inlet lumen 562 and into the housing 520. There,the gases can mix with the medicament delivered from the surfactant tube514 near the opening of the nostril lumens (not pictured). Asillustrated in FIG. 6C, there is a gap between the end of the surfactanttube 514 and the nostril lumens (not illustrated) of the patientinterface 550 that allow inspiratory gases to flow in. In someembodiments, the expiratory gases can then exit the patient interface550 and move around the surfactant tube 514, flow through the outletlumen 582, and exit the adaptor 500 from the outlet port 580.

FIGS. 7A-7G illustrate another embodiment of an adaptor 600. The adaptor600 resembles or is identical to the adaptor 100 in many respects.Accordingly, the numerals used to identify components of the system foradaptor 100 are incremented by one hundred to identify like features ofthe adaptor 600. This number convention generally applies to theremainder of the Figures. Any component disclosed in any embodiment inthis specification can be used in other embodiments. In someembodiments, the adaptor 600 is configured to have an oval tube orientedto present the smallest possible trunk width between the patient's (forexample, the infant) eyes while maintaining a sufficient cross-sectionto provide sufficient air flow.

Turning first to FIGS. 7A and 7B, illustrated is an embodiment of theadaptor 600. Like the adaptor 100, the adaptor 600 can include a housing620 that is fluidly connected to a plurality of conduits to providefluid flow, such as air, and the delivery of aerosolized surfactants tothe patient through the patient interface 650. The adaptor 600 caninclude a housing 620, a plurality of clips 630, an inlet port 660, anoutlet port 680, a pressure port 670, a surfactant port 610 and acoupling surface 640 for engaging a patient interface 650.

In some examples, as with the housing 120, the housing 620 can include asubstantially hollow cylindrical body. The shape of the housing 620 canbe optimized to reduce resistance to flow within the housing 620. Insome examples, the housing 620 can comprise different shapes, forexample, rectangular, square, hexagonal, or semi-circular. In someembodiments the shape of the housing 620 can minimize volume within thehousing 620. This can reduce dead space—therefore reducing the build-upof carbon dioxide within the housing 620. The housing 620 can be compactso as to reduce the weight and bulk of the housing 620 and improvepatient comfort. As discussed with regard to the adaptor 100, thehousing 620 can be configured to both receive gases through aninspiratory tube and aid the exit of gases through an expiratory tube.

The housing 620 can include a coupling surface 640 at an end of thehousing 620 that is proximate to the patient. As illustrated in FIGS.7A-7B, the coupling surface 640 can be rectangular in cross-section. Thecoupling surface 640 can include a first end that is fluidly connectedwith the housing 620 and a second end that is configured to couple withthe patient interface 650. The second end of the coupling surface 640can allow fluid communication between the housing 620 and the patientinterface 650. In some embodiments, a partial barrier can exist betweenthe housing 620 and the first end of the coupling surface 640. Anorifice can thus maintain fluid communication between the housing 620and the patient interface 650. The orifice can direct the flow of gasestoward the patient interface 650. In some examples, the orifice cancontrol the pressure of the gas flow as it enters the patient interface650.

In some embodiments, the patient interface 650 is similar if notidentical to the patient interface 150 of adaptor 100. As discussed, thepatient interface 650 can be configured to be removably coupled with thecoupling surface 640. In some examples the patient interface 650 can becoupled with the coupling surface 640 using adhesives or mechanicalmechanisms such as snap-fit mechanisms. In some embodiments, the patientinterface 650 can be permanently attached to the coupling surface 640using adhesives, snap-fit mechanisms, or welding techniques. FIGS. 7A-7Gillustrate a patient interface 650 that is transparent so as to allowthe engagement between the coupling surface 640 and the patientinterface 650 to be visualized. The patient interface 650 can include asubstantially hollow complementary region 655 that is configured toreceive the coupling surface 640. In some embodiments, the couplingsurface 640 can be configured to receive the complementary region 655 ofthe patient interface 650. In some embodiments, the patient interface650 can be permanently coupled with the adaptor 600. This can provide afully integrated adaptor which may improve the usability of the adaptor600.

As illustrated in FIGS. 7A-7B, in some examples, the patient interface650 can include nasal prongs 652. In some embodiments, the patientinterface 650 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 600can be adapted for use in a surgical application. The patient interface650 can include a diffuser, trocar, or catheter.

In some embodiments, the adaptor 600 can include clips 630 that arepositioned on first and second sides of the housing 620. As illustratedin FIGS. 7A-7B, the first and second sides of the coupling surface 640can be substantially perpendicular to the first and second ends of thecoupling surface 640. In some embodiments, the clips 630 can beconfigured to be mobile clips. For example, the clip 630 can bepositioned on a slidable and/or rotatable bar or cord. In this way, theposition of the clips 630 can be rotated or altered to simplify theattachment of the patient stabilising mechanism to the adaptor 600. Insome embodiments, the clips 630 can be configured to permanently attachto an interface stabilising mechanism.

As discussed above, in some examples, the clips 630 can engage aremovable attachment that is attached to an interface stabilisingmechanism, such as headgear or a hat or bonnet. As described above, anexample of the removable attachment is illustrated in FIGS. 13A and 13B.

In some embodiments, the adaptor 600 can include a plurality of conduitsthat act as the inlet and outlet of air flow that are located adjacentto each. In some embodiments, the plurality of conduits runs parallel toeach other. As illustrated in FIGS. 7A and 7B, as the plurality ofconduits are located adjacent to each other, the inlet port 660 and theoutlet port 680 are interchangeable and can be located on either side ofthe housing 620.

In some examples, the adaptor 600 can include an inlet port 660 that canbe fluidly connected to an inspiratory tube 6 from a humidificationapparatus and allow fluid flow through the inlet tube 664 in a firstdirection. In some embodiments, the inlet tube 664 can include anengagement portion 665 at a first end that engages with the inspiratorytube 6. In some embodiments, the inlet tube 664 is secured to theinspiratory tube 6 using a securing portion 668. The securing portion668 can allow the inlet tube 664 to be removably attached to theinspiratory tube 6. For example, as illustrated in FIGS. 7A and 7B, thesecuring portion 668 can be threaded and configured to engage internalthreading located on a portion of the inspiratory tube 6. However, thesecuring portion 668 can come in any shape and size, such as a tab,latch, or any locking feature that has a complementary securing portionon the inspiratory tube 6. In some embodiments, the securing portion 668can allow the adaptor 600 to be directly attached to the respiratoryassistance system 1. This can help, for example, to reduce the number ofparts in the respiratory assistance system 1 as well as reduce themanufacturing costs.

In some embodiments, the outlet port 680 can be configured to receive anexpiratory tube 4. In some examples, the outlet port 680 can be fluidlyconnected to the respiratory assistance system 1 to allow fluid flowthrough the outlet tube 684 in a second direction. The outlet tube 684can include an engagement portion 665 at a first end that engages withthe expiratory tube 4. In some embodiments, the outlet tube 684 can besecured to the expiratory tube 4 using a securing portion 688. Thesecuring portion 688 can allow the outlet tube 684 to be removablyattached to the expiratory tube 4. For example, as illustrated in FIGS.7A and 7B, the securing portion 688 can be threaded and configured toengage internal threading located on a portion of the expiratory tube 4.However, the securing portion 688 can come in any shape and size, suchas a latch, threaded portion, or any locking feature that has acomplementary securing portion on the expiratory tube 4. As wasdiscussed with regard to the securing portion 668, in some embodiments,the securing portion 688 can allow the adaptor 600 to be directlyattached to the respiratory assistance system 1. This can help, forexample, to reduce the number of parts in the respiratory assistancesystem 1 as well as reduce the manufacturing costs.

In some examples, the inlet tube 664 and the outlet tube 684 areconfigured to extend above and away from the patient. As with theadaptor 300 and adaptor 400, the adaptor 600 retains the narrow body ofthe “over” and “under” design, but, as mentioned above, the connectorsare now side-by-side so connections are interchangeable. As discussed,with regard to the adaptor 600, this design of the inlet tube 664 andthe outlet tube 684 can help to reduce the mass across the patient'sface. In some examples, the inlet tube 664 and the outlet tube 684 canbe more rigid so as to be able to hold onto its shape without contactingthe patient. The inlet tube 664 and the outlet tube 684 can help toreduce the weight perceived by the patient by spreading out orincreasing the distribution of forces from the interface and tubing,reducing patient discomfort. In some embodiments, the location of theinlet port 660 and the outlet port 680 can be alternated.

In some examples, the adaptor 600 can include a pressure tube 674 with apressure port 670 and a pressure lumen 672 that is fluidly connected tothe housing 620. As illustrated in FIG. 6C, the pressure tube 674extends below the pair of conduits (the inlet port 660 and the outletport 680) such that the pressure port 670 is directed towards the faceof the patient. In some embodiments, the pressure port 670 is locatedfurther away from the nose of the patient such that it does not interactwith the patient's face. As the pressure port 670 does not interferewith the patient's face, the pressure port 670 does not need to extendinto a foam block. In some embodiments, the location of the surfactantport 610 and the pressure port 670 can be reversed.

The pressure tube 674 can generally extend vertically between the inletport 660 and outlet port 680 before making an approximately right angleturn towards the housing 620 such that the pressure lumen 672 extendsbetween the inlet port 660 and outlet port 680 through the center of theadaptor 600. In some embodiments, the pressure lumen 672 extends towardsthe housing 620 such that the pressure port 670 and pressure lumen 672are fluidly connected to the housing 620. In some embodiments, thepressure tube 674 is fluidly connected to a pressure line which isfluidly connected to the pressure regulating device 7.

As with the adaptor 100, in some embodiments, the adaptor 600 caninclude nozzle 622 that is configured to connect with an external deviceto provide a fluid connection with the inside of the housing 620. Insome examples, the nozzle 622 can be fluidly connected to anotherconduit to isolate and restrict the mixing of the aerosolized material(for example, a drug) with the air flow coming through the inlet tube664.

As illustrated in FIGS. 7C-7G, in some embodiments, the nozzle 622 canbe fluidly connected to a surfactant tube 614. The surfactant tube 614can have a surfactant port 610 and a surfactant lumen 612. As shown inFIG. 6C, the surfactant port 610 is located closer to the patient'sforehead and is closer to the housing 620 than the pressure port 670. Insome embodiments, the surfactant tube 614 extends above the pair ofconduits (the inlet port 660 and the outlet port 680) such that thesurfactant port 610 is directed away from the face of the patient. Thesurfactant tube 614 can make an approximately right turn towards thehousing 620. In some examples, the surfactant lumen 612 can extendtowards the housing 620 between the inlet port 660 and pressure port 670such that the surfactant tube 614 is on the side of the adaptor 600furthest away from the patient. In some embodiments, the surfactantlumen 612 extends towards the housing 620 such that the surfactant port610 and the surfactant lumen 612 are fluidly connected to the housing620.

In some examples, the surfactant tube 614 can have a surfactant port 610at a first end of the surfactant tube 614 that is configured to befluidly connected to the respiratory assistance system 1 to allow thedelivery of a substance, such as an aerosolized surfactant, through thehousing 620 and to the patient through the patient interface 650.

In some embodiments, the surfactant tube 614 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 614 can have a circularcross-section which ensures that the surfactant lumen 612 does not haveany sharp edges so as to reduce deposition within the surfactant lumen612. The surfactant tube 614 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 610 of the surfactanttube 614 is located directly over the nose so as to reduce thedeposition of medicament within the surfactant lumen 612 and ensuresufficient delivery of medicament to the patient.

In contrast to the adaptor 400, the surfactant port 610 and the pressureport 670 extend from opposing sides of the adaptor 600. The surfactantport 610 and the pressure port 670 directing from opposing side of theadaptor 600 helps to avoid confusion and entanglement of the surfactantport 610 and the pressure port 670.

The body of the adaptor 600 can be divided into a plurality ofcompartments. FIGS. 7C-7G illustrate the configuration of the adaptor600 and the airflow through the tubular body 690, surfactant lumen 612,pressure lumen 672, and the housing 620. As illustrated in FIGS. 7C-7G,the tubular body 690 can be divided into an inlet lumen 662 and anoutlet lumen 682. The plurality of compartments within the adaptor 600can reduce premixing of the medicament received through the surfactantport 610 and the inspiratory gases through the inlet lumen 662 andreduce dilution of the drug by the outgoing gases through the outletport 680. In some examples, the arrangement of the conduits within theadaptor 600 can help to maximize gas flow to the patient. For example,inspiratory gases can enter the adaptor 600 through the inlet port 660and flow through the inlet lumen 662 and into the housing 620. There,the gases can mix with the medicament delivered from the surfactant tube614 near the opening of the nostril lumens (not pictured). Asillustrated in FIG. 6C, there is a gap between the end of the surfactanttube 614 and the nostril lumens (not illustrated) of the patientinterface 650 that allow inspiratory gases to flow in. In someembodiments, the expiratory gases can then exit the patient interface650 and move around the surfactant tube 614, flow through the outletlumen 682, and exit the adaptor 600 from the outlet port 680.

FIGS. 8A-8F illustrate another embodiment of an adaptor 700. The adaptor700 resembles or is identical to the adaptor 100 in many respects.Accordingly, the numerals used to identify components of the system foradaptor 700 are incremented by one hundred to identify like features ofthe adaptor 700. This number convention generally applies to theremainder of the Figures. Any component disclosed in any embodiment inthis specification can be used in other embodiments. In someembodiments, the adaptor 700 is configured to have an oval tube orientedto present the smallest possible trunk width between the patient's (forexample, the infant's) eyes while maintaining a sufficient cross-sectionto provide sufficient air flow. The generally oval shaped inlet tube ortube also helps to provide a substantially lower profile adaptor orpatient interface. The oval inlet tube reduces the distance the adaptoror patient interface 700 extends outwardly from a patient's face when inan operational or in use position. The adaptor 700 may be known as apatient interface since it engages a patient's face with prongs. Turningfirst to FIGS. 8A-8C, illustrated is an embodiment of the adaptor 700.Like the adaptor 100, the adaptor 700 can include a housing 720 that isfluidly connected to a plurality of conduits to provide fluid flow, suchas air, and the delivery of aerosolized surfactants to the patientthrough the patient interface 750.

The adaptor 700 can include a housing 720, a plurality of clips (notshown), an inlet port 760, and outlet port 780, a pressure port 770, asurfactant port 710, and a coupling surface 740 for engaging a patientinterface 750. The pressure port 770 includes an opening and can includea pressure lumen that is inserted through the pressure port oralternatively can include a pressure sensor arrangement mounted on orconnected to the pressure port 770. The pressure port 770 is optionaland the adaptor 700 may not include a pressure port within it.

In some examples, as with the housing 120, the housing 720 can include asubstantially hollow cylindrical body. The shape of the housing 720 canbe optimized to reduce resistance to flow within the housing 720. Insome examples, the housing 720 can comprise different shapes, forexample, rectangular, square, hexagonal, or semi-circular. The housing720 includes smooth curves and radiused corners to improve fluid flowaround corners. In some embodiments the shape of the housing 720 canminimize volume within the housing 720. This can reduce deadspace—therefore reducing the build-up of carbon dioxide within thehousing 720. The housing 720 can be compact so as to reduce the weightand bulk of the housing 720 and improve patient comfort. As discussedwith regard to the adaptor 100, the housing 720 can be configured toboth receive gases through an inspiratory tube and aid the exit of gasesthrough an expiratory tube.

The housing 720 can include a coupling surface 740 at an end of thehousing 720 that is proximate to the patient. As illustrated in FIGS.8A-8D, the coupling surface 740 can have a rectangular cross-section.The coupling surface 740 can include a first end that is fluidlyconnected with the housing 720 and a second end that is configured tocouple with the patient interface 750. The second end of the couplingsurface 740 can allow fluid communication between the housing 720 andthe patient interface 750. In some embodiments, a partial barrier canexist between the housing 720 and the first end of the coupling surface740. An orifice can therefore maintain fluid communication between thehousing 720 and the patient interface 750. The orifice can direct theflow of gases toward the patient interface 750. In some examples, theorifice can control the pressure of the gas flow as it enters thepatient interface 750.

In some embodiments, the patient interface 750 is similar if notidentical to the patient interface 150 of the adaptor 100. In theillustrated embodiments the patient interface 750 comprises sealingnasal prongs that can substantially seal with the nasal openings of apatient. As discussed, the patient interface 750 can be configured to beremovably coupled with the coupling surface 740. In some examples thepatient interface 750 can be coupled with the coupling surface 740 usingadhesives or mechanical mechanisms such as snap-fit mechanisms. In someembodiments, the patient interface 750 can be permanently attached tothe coupling surface 740 using adhesives, snap-fit mechanisms, orwelding techniques. FIGS. 8A-8D illustrate a patient interface 750 thatis transparent so as to allow the engagement between the couplingsurface 740 and the patient interface 750 to be visualized. The patientinterface 750 can include a substantially hollow complementary region755 that is configured to receive the coupling surface 740. In someembodiments, the coupling surface 740 can be configured to receive thecomplementary region 755 of the patient interface 750. In someembodiments, the patient interface 750 can be permanently coupled withthe adaptor 700. This can provide a fully integrated adaptor which mayimprove the usability of the adaptor 700.

As illustrated in FIGS. 8A-8D, in some examples, the patient interface750 can include nostril ports 752. In some embodiments, the patientinterface 750 can include respiratory interfaces such as, but notlimited to, a nasal mask, oral mask, combined nasal and oral mask,tracheal mask, or nasal pillows. In some embodiments, the adaptor 700can be adapted for use in a surgical application. The patient interface750 or 550 can include a diffuser, trocar, or catheter. The patientinterface may also be an invasive interface such as an endotracheal tubethat can be inserted into an airway of a patient. The illustratedinterface 750 is a non-invasive interface and is easier to use since apatient does not need to be intubated or potentially sedated either.This can be particularly useful for neonatal patients or infantpatients.

In some embodiments, the adaptor 700 can include clips (not shown) thatare positioned on first and second sides of the housing 720. Asillustrated in FIGS. 8A-8C, the first and second sides of the couplingsurface 740 can be substantially perpendicular to the first and secondends of the coupling surface 740. In some embodiments, the clips (notshown) can be configured to be mobile clips. For example, the clips (notshown) can be positioned on a slidable and/or rotatable bar or cord. Inthis way, the position of the clips (not shown) can be rotated oraltered to simplify the attachment of the patient stabilising mechanismto the adaptor 700. In some embodiments, the clips (not shown) can beconfigured to permanently attach to an interface stabilising mechanism.

As discussed above, in some examples, the clips (not shown) can engage aremovable attachment that is attached to an interface stabilisingmechanism, such as headgear or a hat or bonnet. As described above, anexample of the removable attachment is illustrated in FIGS. 13A and 13B.Alternatively a headgear may comprise a plurality of straps withremovable couplers at the ends such as hook and loop couplers.

In some embodiments, the adaptor 700 can include a plurality of conduitsthat act as the inlet and outlet of air flow that are located adjacentto each other. In some embodiments, the plurality of conduits runsparallel to each other. FIG. 8D illustrates a vertical cross-sectionalong the length of the adaptor 700. FIG. 8E illustrates a top-half of ahorizontal cross-section along the length of the adaptor 700. FIG. 8Fillustrates a bottom-half of a horizontal cross-section along the lengthof the adaptor 700.

As illustrated in FIGS. 8A-8C and 8E-8F, as the plurality of conduitsare located adjacent to each other, the inlet port 760 and the outletport 780 are interchangeable and can be located on either side of thehousing 720.

In some examples, the adaptor 700 can include an inlet port 760 that canbe fluidly connected to an inspiratory tube 6 from a humidificationapparatus and allow fluid flow from the inlet tube 764 in a firstdirection. In some embodiments, the inlet tube 764 can include anengagement portion 765 at a first end that engages with the inspiratorytube 6. In some embodiments, the inlet tube 764 is secured to theinspiratory tube 6 using a securing portion 768. The securing portion768 can allow the inlet tube 764 to be removably attached to theinspiratory tube 6. For example, as illustrated in FIGS. 8A-8C and8E-8F, the securing portion 768 can be threaded and configured to engageinternal threading located on a portion of the inspiratory tube 6.However, the securing portion 768 can come in any shape and size, suchas a tab, latch, or any locking feature that has a complementarysecuring portion on the inspiratory tube 6. In some embodiments, thesecuring portion 768 can allow the adaptor 700 to be directly attachedto the respiratory assistance system 1. This can help, for example, toreduce the number of parts in the respiratory assistance system 1 aswell as reduce the manufacturing costs. In alternative embodiments thesecuring portion 768 may be a medical taper such as a 22 mm or 15 mmtaper. The inspiratory tube 6 can be push fitted onto the securingportion 768 by urging a portion of the inspiratory tube 6 onto thesecuring portion. The inspiratory tube 6 is held on the medical taper byfriction.

In some embodiments, the outlet port 780 can be configured to receive anexpiratory tube 4. In some examples, the outlet port 780 can be fluidlyconnected to the respiratory assistance system 1 to allow fluid flow ina second direction. The outlet tube 784 can include an engagementportion 765 at a first end that engages with the expiratory tube 4. Insome embodiments, the outlet tube 784 can be secured to the expiratorytube 4 using a securing portion 788. The securing portion 788 can allowthe outlet tube 784 to be removably attached to the expiratory tube 4.For example, as illustrated in FIGS. 8A-8C, the securing portion 788 canbe threaded and configured to engage internal threading located on aportion of the expiratory tube 4. However, the securing portion 788 cancome in any shape and size, such as a latch, threaded portion, or anylocking feature that has a complementary securing portion on theexpiratory tube 4. As was discussed with regard to the securing portionsecuring portion 768, in some embodiments, the securing portion 788 canallow the adaptor 700 to be directly attached to the respiratoryassistance system 1. This can help, for example, to reduce the number ofparts in the respiratory assistance system 1 as well as reduce themanufacturing costs. In alternative embodiments the securing portion 788may be a medical taper such as a 22 mm or 15 mm taper. The expiratorytube 4 can be push fitted onto the securing portion 788 by urging aportion of the expiratory tube 4 onto the securing portion. Theexpiratory tube 4 is held on the medical taper by friction.

In some examples, the inlet tube 764 and the outlet tube 784 areconfigured to extend above and away from the patient. As with theadaptor 300, adaptor 400, adaptor 500, and adaptor 600, the adaptor 700retains the narrow body of the “over” and “under” design, but, asmentioned above, the connectors are now side-by-side so connections areinterchangeable. As discussed, with regard to the adaptor 700, thisdesign of the inlet tube 764 and the outlet tube 784 can help to reducethe mass across the patient's face. In some examples, the inlet tube 764and the outlet tube 784 can be more rigid so as to be able to hold ontoits shape without contacting the patient. The inlet tube 764 and theoutlet tube 784 can help to reduce the weight perceived by the patientby spreading out or increasing the distribution of forces from theinterface and tubing, reducing patient discomfort. In some embodiments,the location of the inlet port 760 and the outlet port 780 can bealternated.

In some examples, the adaptor 700 can include a pressure tube 774 with apressure port 770 and a pressure lumen 772 that is fluidly connected tothe housing 720. In comparison to the adaptor 400, adaptor 500, or theadaptor 600, the pressure tube 774 of the adaptor 700 extendsapproximately perpendicularly from the body of the adaptor 700 such thatthe pressure port 770 is fluidly connected to both the inlet lumen 762and the outlet lumen 782. In some embodiments, the pressure tube 774 isfluidly connected to a pressure line which is fluidly connected to thepressure regulating device 7.

As with the adaptor 100, in some embodiments, the adaptor 700 caninclude a nozzle 722 that is configured to connect with an externaldevice to provide a fluid connection with the inside of the housing 720.In some examples, the nozzle 722 can be fluidly connected to anotherconduit to isolate and restrict the mixing of the aerosolized material(for example, a drug) with the air flow coming through the inlet tube764.

As illustrated in FIG. 8D, in some embodiments, the nozzle 722 can befluidly connected to a surfactant tube 714. The surfactant tube 714 canhave a surfactant port 710 and a surfactant lumen 712. As shown in FIG.8C, in some embodiments, the surfactant tube 714 is approximatelyparallel with the pair of conduits (the inlet port 760 and the outletport 780). Unlike the surfactant tubes (414, 514, 614) of the previouslydisclosed adaptors (400, 500, 600), the surfactant tube 714 does notmake an approximate turn towards the housing 720. The surfactant tube714 opens into a portion of the housing 720 and mixes with theventilation airflow (for example, airflow from a ventilator). Theventilation airflow and surfactant flow are parallel to each other untilthey mix within the housing 720. In some embodiments, this can reducethe likelihood of surfactant deposit within the surfactant lumen 712. Inan alternative embodiment the surfactant tube may open into the housingafter a turn within the surfactant tube, however the turn in thesurfactant tube is a shallow turn of an obtuse angle, i.e. greater than90 degrees. The obtuse angle turn also includes smooth edges and roundededges to reduce collection or deposition of the surfactant.

In some examples, the surfactant tube 714 can have a surfactant port 710at a first end of the surfactant port 710 that is configured to befluidly connected to the respiratory assistance system 1 to allow thedelivery of a substance, such as an aerosolized surfactant, through thehousing 720 and to the patient through the patient interface 750.Alternatively the surfactant port 710 or surfactant nozzle 722 may beconnected to an aerosol generator either directly or through a tube orpipe.

In some embodiments, the surfactant tube 714 can be fluidly connectedwith an external device such as a medicament delivery device. In someembodiments, the medicament delivery device can be a nebulizer, acapillary aerosol generator, or a metered dose inhaler (MDI). Anebuliser such as a flow based nebuliser, for example, can deliveraerosolised surfactant to the patient. In some embodiments, a nebulisercan be configured to deliver a medicament or anaesthetic substance tothe patient.

In some embodiments, the surfactant tube 714 can have a circularcross-section that ensures that the surfactant lumen 712 does not haveany sharp edges so as to reduce deposition within the surfactant lumen712. The surfactant tube 714 is not limited to a tubular shape, and cancomprise any number of shapes. The surfactant port 710 of the surfactanttube 714 is configured so as to reduce the deposition of medicamentwithin the surfactant lumen 712 and ensure sufficient delivery ofmedicament to the patient. Alternatively the surfactant tube 714 mayhave an elliptical or oval cross section. In a further alternative thesurfactant tube 714 may have a polygon cross section such as for exampletriangular, square, rectangular, pentagonal etc. If a polygon crosssection is utilized the polygon shape will have rounded corners andedges to reduce any sharp edges to reduce surfactant deposition.

Similar to the adaptor 600, the surfactant port 710 and the pressureport 770 are located on opposite sides of the adaptor 700. Thesurfactant port 710 and the pressure port 770 located and directed indifferent sides of the adaptor 700 helps to avoid confusion andentanglements of the surfactant port 710 and the pressure port 770.

The body of the adaptor 700 can be divided into a plurality ofcompartments. FIGS. 8C-8F illustrate the configuration of the adaptor700 and the airflow through tubular body 790, surfactant lumen 712,pressure lumen 772, and the housing 720. As illustrated in FIGS. 8C-8F,the tubular body 790 can be divided into the inlet lumen 762 and theoutlet lumen 782. As will be discussed in more detail below, the housing720 can have a number of different configurations to provide fordifferent amounts of airflow from the inlet lumen 762/pressure lumen 772and the surfactant lumen 712.

In some examples, the arrangement of the conduits within the adaptor 700can help to maximize gas flow to the patient. For example, inspiratorygases can enter the adaptor 700 through the inlet port 760 and flowthrough the inlet lumen 762 and into the housing 720. There, the gasescan mix with the medicament delivered from the surfactant tube 714 nearthe opening of the nostril lumens 754. As illustrated in FIG. 8C or 8D(and described in more detail with regard to the housing 720), there isa gap or hollow space between the end of the surfactant tube 714 and thenostril lumens 754 of the patient interface patient interface 750 thatallow inspiratory gases to mix with. In some embodiments, the expiratorygases can then exit the patient interface 750 and through the housing720, flow through the outlet lumen 782, and exit the adaptor 700 fromthe outlet port 780. In some instances within use inlet gases enters thehousing 720 from the inlet lumen and can turn and exit out of the outletlumen 782 without going to the patient.

In some embodiments, the embodiment of the adaptor 700 illustrated inFIGS. 8A-8F are configured to provide an air flow path such that the airflowing past the infant (i.e. in a bias flow path) goes from the inletlumen 762 to the outlet lumen 782 around a bend. Bias flow occursbecause the gas flow rate may be higher than the patient's inspiratorydemand, or the patient may be exhaling. Accordingly, rather thanentering the patient, the excess or bias gas flow will continue into theexpiratory limb. Many medicament delivery adaptors suffer from an issuewith medicament being washed out through the bias flow, and neverentering the patient. This occurs because the medicament delivery pointis either upstream of or within the bias flow path. As will beillustrated in FIGS. 9A-9D, the housing 720, 820, 920, 1020 can beconfigured to keep the surfactant flow path or delivery point out of thebias flow path such that the inlet lumen 762 and outlet lumen 782 arefluidly connected upstream of the point where surfactant is delivered tothe air flow path. Delivering surfactant to the air flow path after ordownstream of the exchange of air from the inlet lumen 762 and theoutlet lumen 782 ensures less dilution of the surfactant to the infantas well as reducing the deposition of the surfactant on the interior ofthe adaptor 700.

In some examples, the above disclosed adaptors are configured to providegreater stability over the infant's face. For example, the abovedisclosed adaptors are retained fairly close to the face of the infantsuch that it does not extend high off the infant's face. In this way,the disclosed adaptor is firmly secured to the face of the infant. Anadaptor that extends high off the infant's face increases the risk thatmovement of the adaptor will cause bending and/or twisting of theadaptor about the infant's nose. Movement (e.g. bending, twisting) ofthe adaptor about the infant' s nose can cause nasal trauma to theinfant. This is particularly of great concern where the patient is apremature baby as premature babies are particularly fragile.

In some examples, the size of the above disclosed adaptors allows forlonger use on an infant (e.g. 7 days). By providing for an adaptor thatcan be used for an extended period of time without adjustment, thedisclosed adaptor can reduce irritation and trauma to the nose of theinfant.

FIGS. 9A-9D illustrates an embodiment of the housing 720. In someembodiments, the housing 720 is configured to provide a mixture ofairflow from the CPAP and aerosolized surfactant or aerosolizedmedicaments or aerosolized drugs from the nozzle, to the patient. Asshown in FIGS. 9A-9B, in some examples, the housing 720 can be dividedinto a plurality of compartments. As discussed above and in more detailbelow, the configuration of the housing 720 can provide for improveddrug delivery to the patient.

In some examples, the inside of the housing 720 can include a divider726 that divides the housing 720 to provide a housing airflow entrance725 with a housing airflow pathway 724 and a housing surfactant entrance727 with a housing surfactant lumen 728. In some embodiments, thehousing airflow entrance 725 is configured to fluidly connect with theboth the inlet lumen 762 and the outlet lumen 782. This can allowinspiratory air from the inlet lumen 762 and expiratory air from theoutlet lumen 782 to flow through the housing airflow pathway 724.

Similarly, in some embodiments, the housing surfactant lumen 728 isconfigured to fluidly connect with the surfactant lumen 712. Asdiscussed above, this can allow surfactant to flow from the surfactantlumen 712 into the housing surfactant lumen 728 without mixing with theinspiratory air from the inlet lumen 762.

FIGS. 9C-9D provides a view of the housing 720 from the housing exit723, wherein the entrance to the housing 720 (the housing airflowentrance 725 and the housing surfactant entrance 727) is orientedupwards. As shown, the divider 726 provides two separate compartmentsfor the inspiratory/expiratory airflow and the surfactant flow. Asdiscussed above, the housing 720 near the housing exit 723 includes anundivided portion 729 that allows the inspiratory air from the inletlumen 762 to mix with the surfactant from the surfactant lumen 712before being delivered to the patient. As seen in FIG. 9C the dividergoes through a turn section but the turn portion includes rounded edgesto reduce aerosolized surfactant deposition at the turn. The housingairflow pathway 724 provides inspiratory airflow into the undividedportion to allow mixing of inspiratory airflow and aerosolizedsurfactant.

As shown in FIG. 9D, in some embodiments, the cross-section of thehousing 720 is asymmetrical. For example, the housing airflow pathway724 and the housing surfactant lumen 728 can both form a plurality ofrectangular profiles. In some embodiments, the housing surfactant lumen728 can form a rectangular profile that is larger than the housingairflow pathway 724. As illustrated in FIG. 9E, the larger rectangularprofile of the housing surfactant lumen 728 can allow for greaterdelivery of surfactant directly to the nostril lumens 754 of the nasalprongs 752. A plurality of different nasal prong sizes can beinterchangeably attached to the housing 720.

FIGS. 10A-10C, 11A-11C, and 12A-12D illustrate housing 820, housing 920,and housing 1020 that are alternative embodiments of the housing 720.Each of the housing 820, housing 920, and housing 1020 resemble thehousing 720. Accordingly, the numerals used to identify components ofthe housing 820, 920, 1020 are incremented by one hundred to identifylike features of the housing 720. This number convention generallyapplies to the remainder of the Figures. Any component disclosed in anyembodiment in this specification can be used in other embodiments.

Turning first to the housing 820, FIGS. 10A-10C illustrate an embodimentof the housing 820. In some embodiments, the housing 820 is configuredto provide a mixture of airflow from the CPAP and surfactant from thenozzle to the patient. As shown in FIGS. 10A-10C, in some examples, thehousing 820 can be divided into a plurality of compartments. Asdiscussed above and in more detail below, the configuration of thehousing 820 can provide for improved drug delivery to the patient.

In some examples, the inside of the housing 820 can include a divider826 that divides the housing 820 to provide a housing airflow entrance825 with a housing airflow pathway 824 and a housing surfactant entrance827 with a housing surfactant lumen 828. In some embodiments, thehousing airflow entrance 825 is configured to fluidly connect with boththe inlet lumen 762 and the outlet lumen 782 of an adaptor (for examplethe adaptor 700 of FIG. 9A). As discussed with regard to the divider 726of the housing 720, this can allow inspiratory air from the inlet lumen762 and expiratory air from the outlet lumen 782 to flow through thehousing airflow pathway 824.

Similarly, in some embodiments, the housing surfactant lumen 828 isconfigured to fluidly connect with the surfactant lumen 712. Asdiscussed above, this can allow surfactant to flow from the surfactantlumen 712 into the housing surfactant lumen 828 without mixing with theinspiratory air from the inlet lumen 762.

FIG. 10B provides a view of the housing 820 from the housing exit 823,wherein the entrance to the housing 820 (the housing airflow entrance825 and the housing surfactant entrance 827) is oriented upwards. Asshown, the divider 826 forms angled portions divider 826 a and divider826 b to provide three separate compartments (housing airflow pathway824 (shown as housing airflow pathway 824 a and housing airflow pathway824 b) and housing surfactant lumen 828) for the inspiratory/expiratoryairflow and the surfactant flow. As discussed above, the housing 820near the housing exit 823 includes an undivided portion 829 that allowsthe inspiratory air from the inlet lumen 762 to mix with the surfactantfrom the surfactant lumen 712 before being delivered to the patient.

As shown in FIG. 10C, in some embodiments, the cross-section of thehousing 820 is asymmetrical. For example, the housing airflow pathway824 forms a trapezoid from divider 826 a and divider 826 b. As discussedabove, this causes housing surfactant lumen 828 to form housing airflowpathway 824 a and housing airflow pathway 824 b on either side of thehousing airflow pathway 824. As illustrated in FIG. 10C, the centeredtrapezoidal profile of the housing surfactant lumen 828 can allow forgreater delivery of surfactant directly to the nostril lumens 754 of thenasal prongs 752. In some embodiments, airflow from the inlet lumen762/outlet lumen 782 can pass down the sides of the housing surfactantlumen 828 through housing airflow pathway 824 a and housing airflowpathway 824 b.

Turning next to the housing 920, FIGS. 11A-11C illustrate an embodimentof the housing 920. In some embodiments, the housing 920 is configuredto provide a mixture of airflow from the CPAP and surfactant from thenozzle to the patient. As shown in FIGS. 11A-11C, in some examples, thehousing 920 can be divided into a plurality of compartments. Asdiscussed above and in more detail below, the configuration of thehousing 920 can provide for improved drug delivery to the patient.

In some examples, the inside of the housing 920 can include a divider926 that divides the housing 920 to provide a housing airflow entrance925 with a housing airflow pathway 924 and a housing surfactant entrance927 with a housing surfactant lumen 928. In some embodiments, thehousing airflow entrance 925 is configured to fluidly connect with boththe inlet lumen 762 and the outlet lumen 782 of an adaptor (for examplethe adaptor 700 of FIG. 9A). As discussed with regard to the divider 726of the housing 720, this can allow inspiratory air from the inlet lumen762 and outlet lumen 782 to flow through the housing airflow pathway824.

Similarly, in some embodiments, the housing surfactant lumen 928 isconfigured to fluidly connect with the surfactant lumen 712. Asdiscussed above, this can allow the surfactant to flow from thesurfactant lumen 712 into the housing surfactant lumen 928 withoutmixing with the inspiratory air from the inlet lumen 762.

FIGS. 11B provides a view of the housing 920 from the housing exit 923,wherein the entrance of the housing 920 (the housing airflow entrance925 and the housing surfactant entrance 927) is oriented upwards. Asshown, the divider 926 forms walled divider 926 a and divider 926 b toprovide three separate compartments (housing airflow pathway 924 (shownas housing airflow pathway 924 a and housing airflow pathway 924 b) andhousing surfactant lumen 928) for the inspiratory expiratory airflow andthe surfactant flow. As discussed above, the housing 920 near thehousing exit 923 includes an undivided portion 929 that allows theinspiratory air from the inlet lumen 762 to mix with the surfactant fromthe surfactant lumen 712 before being delivered to the patient.

As shown in FIG. 11C, in some embodiments, the cross-section of thehousing 920 is asymmetrical. For example, the housing airflow pathway924 forms a rectangular from the divider 926 a and divider 926 b. As canbe seen in FIG. 11B the divider 926 a and 926 b are parallel to eachother and extend parallel to each other. Each of the dividers 926 a and926 b extend vertically from a base of the housing 920. As discussedabove, this causes the housing surfactant lumen 928 to form 928 a and928 b on either side of the housing airflow pathway 924. As illustratedin FIG. 11C, the rectangular profile of the housing surfactant lumen 928is centered which can allow for greater delivery of surfactant directlyto the nostril lumens 754 of the nasal prongs 752. In some embodiments,airflow from the inlet lumen 762/outlet lumen 782 can pass down thesides of the housing surfactant lumen 928 through housing airflowpathway 924 a and housing airflow pathway 924 b.

FIGS. 12A-12D illustrates an embodiment of the housing 1020. In someembodiments, as discussed with the other housings above, the housing1020 is configured to provide a mixture of airflow from the CPAP andsurfactant from the nozzle to the patient. As shown in FIGS. 12A-12D, insome examples, the housing 1020 can be divided into a plurality ofcompartments. As discussed above, and in more detail below, theconfiguration of the housing 1020 can provide for improved drug deliveryto the patient.

In some examples, the housing 1020 can include a divider 1026 thatdivides the housing 1020 to provide a housing airflow entrance 1025 witha housing airflow pathway 1024 and a housing surfactant entrance 1027with a housing surfactant lumen 1028. In some embodiments, the housingairflow entrance 1025 is configured to fluidly connect with both theinlet lumen and the outlet lumen from the adaptors (for example inletlumen 762 and outlet lumen 782). As discussed with regard to the divider726 of the housing 720, this can allow inspiratory air from the inletlumen 762 and the expiratory air from the outlet lumen 782 to flowthrough the housing airflow pathway 1024.

Similarly, in some embodiments, the housing surfactant lumen 1028 isconfigured to fluidly connect with the surfactant lumen 712. Asdiscussed above, this can allow surfactant to flow from the surfactantlumen 712 into the housing surfactant lumen 1028 without mixing with theinspiratory air from the inlet lumen 762.

FIGS. 12B-12C provide a view of the housing 1020 from the housing exit1023 wherein the entrance to the housing 1020 (the housing airflowentrance 1025 and the housing surfactant entrance 1027) is orientedupwards. As shown, the divider 1026 forms angled dividers 1026 a and1026 b such that the housing airflow pathway 1024 has a curved surface.In some embodiments, this can provide three separate compartments withinthe housing 1020 (for example, the housing airflow pathway 1024 (shownas housing airflow pathway 1024 a and housing airflow pathway 1024 b)and housing surfactant lumen 1028) for the inspiratory/expiratoryairflow and the surfactant flow. As illustrated in FIG. 12B anddiscussed above, the housing 1020 near the housing exit 1023 can includean undivided portion 1029 that allows the inspiratory airflow from theinlet lumen 762 to mix with the surfactant from the surfactant lumen 712before being delivered to the patient.

As shown in FIG. 12D, in some embodiments, the cross-section of thehousing 1020 is asymmetrical. For example, the housing surfactant lumen1028 forms a rounded triangle from the dividers 1026 a and 1026 b. Asdiscussed above, this causes housing airflow pathway 1024 to form afirst housing airflow pathway 1024 a and a second housing airflowpathway 1024 b on either side of the housing surfactant lumen 1028. Asillustrated in FIG. 10D, the centered triangular profile of the housingsurfactant lumen 1028 can allow for greater delivery of surfactantdirectly to the nostril lumens 754 of the nasal prongs 752. As can beseen in FIG. 10D the housing surfactant lumen 1028 is also betteraligned with the prongs to provide a more direct flow path for thesurfactant and air mixture to the prongs 752. In some embodiments, therounded cross-section of the housing surfactant lumen 1028 can reducethe amount of surfactant deposited within the housing surfactant lumen1028. In some examples, airflow from the inlet lumen 762/outlet lumen782 can pass down the sides of the housing surfactant lumen 1028 throughhousing airflow pathway 1024 a and housing airflow pathway 1024 b. Theaerosolized surfactant can be received at the surfactant port 710 and bereceived by the surfactant lumen 1028. The aerosolized surfactant canmix with the incoming gases flow from the housing airflow pathway andthen be delivered to a patient via the nostrils. The housing surfactantlumen 1028 is larger in cross sectional area than each of the housingair flow lumens 1024 a, 1024 b. This helps for an adequate amount ofaerosolized surfactant to be received within the undivided section ofthe housing 1023 to allow adequate mixing and delivery of aerosolizedsurfactant or other medicaments to the nostrils of the patient via theprongs 752. The cross sectional area of the housing surfactant lumen1028 being greater than the cross sectional area of the housing air flowlumens 1024 a, 1024 b also helps to reduce deposition of aerosolizedsurfactant within the surfactant lumen. The shape of the housingsurfactant lumen 1028 may be a diffuser or act as a diffuser assurfactant moves from the surfactant tube 714 and into the housingsurfactant lumen. The housing surfactant lumen may flare outwardly as itextends toward the prongs and the undivided portion thereby reducing thevelocity of delivered surfactant. This reduced velocity may encourageimproved mixing with the airflow and thereby reducing the amount ofsurfactant deposition.

In some embodiments, the adaptor can include pressure and surfactantlumens that are nested together on the side of the adaptor away from thepatient. In some embodiments, the surfactant port or the nozzle in theadaptor can be bifurcated and may optionally include a pressure sensingnozzle that faces the patient. In some examples, the pressure sensingnozzle can provide more accurate pressure sensing. In some embodimentsthe adaptor any suitable patient interface can be used interchangeablywith the adaptor, and in particular with the housing of the adaptor. Thevarious adaptors described herein are described as being suitable fordelivering aerosolized surfactant to a patient. The adaptors and patientinterfaces described herein can also be used to deliver otheraerosolized products such as asthma drugs, or other respiratorytreatment medicines or drugs. The adaptors as described herein may alsobe used to deliver nebulized drugs or medicaments for the treatment ofrespiratory illness such as for example, COPD (Chronic obstructivepulmonary disease), asthma, cystic fibrosis or other respiratorydiseases or illnesses. The adaptor may also be configured to deliveraerosolized water to provide additional humidity therapy.

In some embodiments, the aforementioned disclosed adaptors can include asecurement system for retaining, holding, or securing pressure and/orsurfactant lumens in position on a patient's face. In some embodiments,the pressure lumen is configured to be fluidly connected to the pressuretube and the surfactant lumen is configured to be fluidly connected tothe surfactant tube described herein. In some embodiments, thesecurement system comprises a two-part releasable attachment orconnection arrangement. The releasable connection arrangement actsbetween a pair of components that are affixed to the patient and thepressure and/or surfactant tube respectively. Several such securementsystems are described in Applicant's U.S. application Ser. No.14/395,047, filed on Apr. 17, 2013.

An example of the attachment mechanism of Applicant's U.S. applicationSer. No. 14/395,047 is hereby reproduced as FIGS. 18-20.

In reproduced FIGS. 18-20, the two-part releasable attachment mechanismcan further include structures to retain the pressure and/or surfactanttube. In some embodiments, these structures can be holder, clips, flaps,etc.

For example, as illustrated in FIG. 18, the two-part releasableattachment mechanism can include a panel that is configured to be foldedonto the dermal patch so as to retain the tube. The dermal patch 1610and the panel 1620 are coupled together at an edge region 1613. Tocouple the first and second parts of the two-part releasable attachmentsystem together, the panel is folded onto the dermal patch to bring thepatient side 1622 of the panel adjacent to the interface side 1612 ofthe dermal patch to couple the first and second parts 1614, 1624 of thetwo-part connection system together to capture or sandwich the tube 1602there between.

As another example, FIG. 19 illustrates the two-part releasableattachment mechanism further including a clip for securing a pressureand/or surfactant tube. The dermal patch 1710 for adhering to the skinof the patient can include a securement clip 1720 that is attached to orintegrally formed with the dermal patch. The securement clip includes arecess or cavity or channel for receiving the tube 1702. The recess isopen so that a section of the tube may be pushed in a lateral directionwith respect to a longitudinal axis of the tube into the clip. An end ofthe tube need not be pushed through the clip for securement. The recesscan have a lateral dimension similar to or slightly smaller than adiameter of the tube so that the tube is gripped firmly by the clip. Inone embodiment, the clip is releasable from the dermal patch. Forexample, a two-part connection system as described previously may beapplied between the clip and the dermal patch. Alternatively, the clipmay be releasably attached to a patient interface 1700.

FIG. 20 illustrates the two-part releasable attachment mechanism havinga wing portion that is configured to wrap about and secure the pressureand/or surfactant tube. The securement system 1805 can include a dermalpatch 910 for attaching to the face of a patient. The dermal patchcomprises a wing portion 932 for wrapping about the tube 2 once the tubehas been correctly positioned in the patient's nostril.

The adaptors disclosed herein can also be used with the fixationstructures disclosed in Applicant's PCT App. No. PCT/NZ2016/050050,filed on Mar. 30, 2016 which is hereby incorporated by reference. Anexample of the fixation structures of Applicant's PCT App. No.PCT/NZ2016/050050 is hereby reproduced as FIGS. 21A-21B.

FIGS. 21A-21B illustrates an embodiment of a fixation structure that canbe configured to secure the pressure and/or surfactant tube. FIGS. 21Aand 21B illustrate the fixation structure assembly having perforatedsections that allow for the removal of the fixation structure from thetube to be secure.

A close-up of a face of a patient is shown, with a nose N and mouth M.The fixation structure assembly 1900 may be torn along tear line T,detaching one of the separable extensions 1904B. In the illustratedembodiment, a pair of perforated sections links the body 1902 with oneof the separable extensions 1904A, 1904B. The body 1902 and theseparable extension 1904A still attached to the body 1902 may be placedon one side of the face, and the detached separable extension 1904B maybe adhered to the other side of the face via use of the adhesive portion1908B, thus exposing the fixation element 1910B of the detachedseparable extension 604B. The tube 1940 can be placed over the body1902, and the separable extension 1904A attached to the body 1902 can befolded to cover the tube 1940.

As shown in FIGS. 21A-21B, the tube 1940 can be positioned in theperforated area (for example, the first intermediate region 1905 A) oradjacent the perforated area. This can facilitate quick and simpleremoval of the fixation structure assembly 1900 from the tube 1940. As aresult, the tube 1940 does not necessarily have to be removed as thefixation structure is removed, and a healthcare provider is then notrequired to reinsert the tube 1940 following removal of the fixationstructure assembly 1900, reducing the number of steps required.Positioning the tube 1940 in or near the perforated area can aid inenabling the fixation structure assembly 1900 to be folded and/or tostick to itself. For example, this can aid in the separable extension1904A being folded over the body 1902.

In some examples, the moulding part-line could also be down the centralplane of symmetry of the adaptor (instead of splitting along thethreaded connectors). In some examples, the threaded connectors can alsobe arranged with their axes parallel to the plane of symmetry but offsetfrom the center so as to create space between them. In some examples,this can allow for a more compact arrangement and simpler tooling, withless complex movements. This can also possibly include the pressure portfacing longitudinally between them.

It should be noted that various changes and modifications to thepresently preferred embodiments described herein will be apparent tothose skilled in the art. Such changes and modifications may be madewithout departing from the spirit and scope of the apparatus and systemsof the disclosure and without diminishing its attendant advantages. Forinstance, various components may be repositioned as desired. It istherefore intended that such changes and modifications be includedwithin the scope of the apparatus and systems of the disclosure.Moreover, not all of the features, aspects and advantages arenecessarily required to practice the present apparatus and systems ofthe disclosure. Accordingly, the scope of the present apparatus andsystems of the disclosure is intended to be defined only by the claimsthat follow.

Reference to any prior art in this specification is not, and should notbe taken as, an acknowledgement or any form of suggestion that thatprior art forms part of the common general knowledge in the field ofendeavour in any country in the world.

Wherein the foregoing description reference has been made to integers orcomponents having known equivalents thereof, those integers are hereinincorporated as if individually set forth.

Unless the context clearly requires otherwise, throughout thedescription and the claims, the words “comprise”, “comprising”, and thelike, are to be construed in an inclusive sense as opposed to anexclusive or exhaustive sense, that is to say, in the sense of“including, but not limited to”.

The apparatus and system of the disclosure may also be said broadly toconsist in the parts, elements and features referred to or indicated inthe specification of the application, individually or collectively, inany or all combinations of two or more of said parts, elements orfeatures.

1. An adaptor for medicament delivery comprising: a tubular body havinga first end and a second end, wherein the tubular body comprises: aninlet tube having an inlet port at the first end and an outlet at thesecond end, wherein the inlet port is configured to be connected to aninspiratory conduit for receiving a flow of gases, an outlet tubeadjacent to the inlet tube having an outlet port at the first end and aninlet at the second end, wherein the outlet port is configured to beconnected to an expiratory conduit for dispensing the flow of gases, anda surfactant delivery tube adjacent to a portion of at least one of theinlet tube and the outlet tube, wherein the surfactant delivery tubecomprises an inlet port at the first end and an outlet at a second end,wherein the inlet port is configured to connect to a source ofmedicament; a housing having a first end and a second end, wherein thefirst end of the housing is attached to the second end of the tubularbody; and a patient interface configured to be connected to the secondend of the housing, wherein the patient interface is in fluidcommunication with an airway of a patient.
 2. The adaptor of claim 1,wherein the housing is permanently attached to the tubular body.
 3. Theadaptor of claim 1, wherein the tubular body and the housing comprise arigid plastic.
 4. The adaptor of claim 1, wherein the housing comprisesa divider to separate the flow of gases from a flow of medicament. 5.The adaptor of claim 4, wherein at least a portion of the housing isconfigured to allow the flow of gases to mix with the flow ofmedicament.
 6. The adaptor of claim 1, wherein the flow of medicamentcomprises an aerosolized surfactant.
 7. The adaptor of claim 4, whereinthe divider comprises angled sidewalls.
 8. The adaptor of claim 7,wherein the divider further comprises a rounded portion connecting theangled sidewalls to improve fluid flow around corners.
 9. The adaptor ofclaim 4, wherein the divider is configured to provide a plurality offluid entryways into an interior of an undivided portion of the housing.10. The adaptor of claim 4, wherein the divider comprises straight wallsto form rectangular fluid entryways to the interior of the undividedportion of the housing.
 11. The adaptor of claim 1, wherein across-section of a portion of the housing in fluid communication withthe surfactant delivery tube is greater than a cross-section of aportion of the housing in fluid communication with the inlet tube andthe outlet tube, and wherein the greater cross-section of the portion ofthe housing in fluid communication with the surfactant delivery tube isconfigured to reduce deposition of medicament within the surfactantdelivery tube.
 12. The adaptor of claim 1, wherein the patient interfacecomprises a pair of prongs.
 13. The adaptor of claim 12, wherein thenasal prongs are sized to fit the nares of the patient.
 14. The adaptorof claim 12, wherein the patient interface is configured tointerchangeably attach to a plurality of different nasal prong sizes.15. The adaptor of claim 1, wherein the patient interface is press-fitonto the second end of the housing.
 16. The adaptor of claim 1, whereinthe patient interface is removably connected to the second end of thehousing.
 17. The adaptor of claim 1, wherein the tubular body furthercomprises a pressure port connected to a pressure sensor, wherein thepressure sensor is configured to measure air pressure flowing throughthe pressure port.
 18. The adaptor of claim 17, wherein the tubular bodyfurther comprises a pressure tube connected to the housing.
 19. Theadaptor of claim 17, wherein the pressure port and the inlet port of thesurfactant delivery tube are on opposing sides of the adaptor.
 20. Theadaptor of claim 1 wherein the tubular body comprises an elongated ovalcross-section. 21.-55. (canceled)